Organization
CHRISTOPHER J CLARK, DDS, PA
Active
Other names
Dental Center at Brier Creek
Organization subpart
No
Provider details
NPI number
Authorized official
CHRISTOPHER J CLARK DDS (OWNER/DENTIST)
(910) 863-2377
Entity
Organization
Contact information
Practice address
7841 ALEXANDER PROMENADE PL, SUITE 100, RALEIGH, NC 27617-1913
(910) 863-2377
(910) 863-2555
Mailing address
PO BOX 160, BLADENBORO, NC 28320-0160
(910) 863-2377
(910) 863-2555
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5901223
—
NC
01
—
749621
UNITED CONCORDIA
—
Enumeration date
04/07/2010
Last updated
04/07/2010
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