Individual
DR. JERRY R CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
1115 W FRIENDLY AVE, GREENSBORO, NC 27401-1844
(336) 273-2528
(336) 273-8038
Mailing address
1115 W FRIENDLY AVE, GREENSBORO, NC 27401-1844
(336) 273-2528
(336) 273-8038
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
3338
PA
Other
Enumeration date
10/28/2009
Last updated
10/28/2009
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