Individual
GARY K. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
9730 S 700 E STE 106, SANDY, UT 84070-4503
(801) 572-1130
Mailing address
9730 S 700 E STE 106, SANDY, UT 84070-4503
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
141551-9922
UT
Other
Enumeration date
05/30/2007
Last updated
07/08/2007
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