Individual
BRENT GILFORD CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
US 23 HAYES COMPLEX, BETSY LAYNE, KY 41605-0001
(606) 478-9090
(606) 478-9191
Mailing address
PO BOX 1, BETSY LAYNE, KY 41605-0001
(606) 478-9090
(606) 478-9191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
4980
KY
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
4980
KY
Other
Enumeration date
02/07/2007
Last updated
09/11/2025
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