Individual
TERESA MARIE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
R.D.A.
Contact information
Practice address
7218 BIRCH BARK DRIVE, FAIRVIEW, TN 37062
(615) 799-5438
Mailing address
7218 BIRCH BARK DRIVE, FAIRVIEW, TN 37062
(615) 799-5438
Taxonomy
Speciality
Code
Description
License number
State
126800000X
Dental Assistant
Primary
3436
TN
Other
Enumeration date
10/26/2006
Last updated
07/08/2007
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