Individual
DR. LINDBERG CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
15024 MARTIN LUTHER KING JR BLVD, GULFPORT, MS 39501
(228) 864-0003
(228) 864-8553
Mailing address
PO BOX 475, BILOXI, MS 39533
(228) 374-2494
(228) 374-2713
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
204683
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0060061
—
MS
Enumeration date
03/02/2006
Last updated
06/13/2008
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