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Individual

CHARLES LAWRENCE CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
444 CEDAR ST STE 208, SAINT PAUL, MN 55101-2186
(651) 222-1201
(651) 760-8633
Mailing address
PO BOX 2054, INVER GROVE HEIGHTS, MN 55076-8054
(507) 421-0610

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5001509-15
WI
1223G0001X
General Practice Dentistry
Primary
D8160
MN

Other

Enumeration date
02/01/2007
Last updated
03/02/2025
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