Individual
ANDREW M. CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6800 MAIN ST, SUITE 315, DOWNERS GROVE, IL 60516-3493
(630) 969-5350
Mailing address
6800 MAIN ST, SUITE 315, DOWNERS GROVE, IL 60516-3493
(630) 969-5350
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
019.026383
IL
Other
Enumeration date
09/20/2006
Last updated
05/06/2021
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