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Individual

DR. TYLOR RAY CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
4274 N EAGLE RD, BOISE, ID 83713-0726
(208) 938-8228
Mailing address
6039 W MIKONOS ST, MERIDIAN, ID 83646-8710
(208) 999-0296

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5381516
ID

Other

Enumeration date
05/28/2026
Last updated
05/28/2026
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