Individual
BENJAMIN R CLARKE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2600
Mailing address
4700 LAS VEGAS BLVD N, NELLIS AFB, NV 89191-6600
(702) 653-2600
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
21488
TX
Other
Enumeration date
08/18/2005
Last updated
05/27/2021
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