Organization
W.A. CLARK D.D.S., P.L.L.C.
Active
Other names
Clark Pediatric Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. MARLE CLARK (OFFICE MANAGER)
(405) 503-9615
Entity
Organization
Contact information
Practice address
1813 EASTCHESTER DR, SUITE 100, HIGH POINT, NC 27265-1573
(405) 503-9615
Mailing address
612 BELLEMEADE ST, GREENSBORO, NC 27401-1903
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
8057
NC
Other
Enumeration date
03/20/2016
Last updated
03/20/2016
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