Individual
DR. DAVID MICHAEL CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
799 NORTHERN BLVD, SOUTH ABINGTON TOWNSHIP, PA 18411-9087
(570) 586-1700
(570) 586-1900
Mailing address
799 NORTHERN BLVD, SOUTH ABINGTON TOWNSHIP, PA 18411-9087
(570) 586-1700
(570) 586-1900
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
046057-1
NY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DA 026947 A
PA
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
DS 026947 L
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1476589
—
PA
Enumeration date
06/12/2006
Last updated
01/07/2016
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