Individual
LAURIE KATHLEEN CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
RDH
Contact information
Practice address
777 E GALVESTON ST, CHANDLER, AZ 85225-8273
(480) 812-7900
Mailing address
14000 N 94TH ST UNIT 2176, SCOTTSDALE, AZ 85260-7792
(602) 909-0587
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
H01509
AZ
Other
Enumeration date
06/24/2014
Last updated
06/24/2014
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