Individual
DR. CLARK O TAYLOR
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.,D.D.S.
Contact information
Practice address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 549-6600
Mailing address
805 S RESERVE ST, MISSOULA, MT 59801-2104
(406) 549-6600
Taxonomy
Speciality
Code
Description
License number
State
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
7822
MT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1689745804
—
MT
Enumeration date
11/10/2006
Last updated
03/30/2011
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