Individual
DENNIS J CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
143 HOSPITAL DR STE 112A, STATE COLLEGE, PA 16803-5500
(814) 865-3566
(814) 863-7803
Mailing address
1850 E PARK AVE, SUITE 112, STATE COLLEGE, PA 16803-6705
(814) 865-3566
(814) 863-7803
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
MA052887
PA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
MA052887
LICENSE
PA
Enumeration date
10/24/2007
Last updated
09/15/2025
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