Individual
DR. EDWARD LEE CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2727 SW 17TH PL, REDMOND, OR 97756-1297
(541) 548-3896
(541) 548-1859
Mailing address
2727 SW 17TH PL, REDMOND, OR 97756-1297
(541) 548-3896
(541) 548-1859
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D6918
OR
Other
Enumeration date
07/31/2006
Last updated
07/08/2007
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