Individual
DR. MICHAEL KENNETH CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
27725 SANTA MARGARITA PKWY, SUITE 130, MISSION VIEJO, CA 92691-6704
(949) 470-3672
(949) 472-2095
Mailing address
27725 SANTA MARGARITA PKWY, SUITE 130, MISSION VIEJO, CA 92691-6704
(949) 470-3672
(949) 472-2095
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
41907
CA
Other
Enumeration date
06/14/2013
Last updated
06/14/2013
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