Organization
CLARK ORAL & FACIAL SURGERY
Active
Other names
Clark Oral & Facial Surgery
Organization subpart
No
Provider details
NPI number
Authorized official
DR. PAUL CLARK III DMD, MD (SURGEON, OWNER)
(503) 927-6845
Entity
Organization
Contact information
Practice address
1502 LOCUST ST N STE 103, TWIN FALLS, ID 83301-6375
(208) 831-2900
Mailing address
1502 LOCUST ST N STE 103, TWIN FALLS, ID 83301-6375
(208) 831-2900
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
—
—
Other
Enumeration date
01/08/2024
Last updated
01/08/2024
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