Organization
DR. CHRISTOPHER J CLARK DDS AND ASSOCIATES
Active
Other names
Dental Center At Waterford
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J CLARK DDS (OWNER)
(910) 383-0100
Entity
Organization
Contact information
Practice address
509 OLDE WATERFORD WAY, 300, LELAND, NC 28451-4125
(910) 383-0100
(910) 383-0121
Mailing address
509 OLDE WATERFORD WAY, 300, LELAND, NC 28451-4125
(910) 383-0100
(910) 383-0121
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
7917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5906097
—
NC
Enumeration date
02/29/2008
Last updated
06/23/2008
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