Individual
JOHN SAUNDERS CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
411 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-8355
Mailing address
411 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-8355
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
1750-77
MS
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR-050-82
MS
Other
Enumeration date
10/11/2006
Last updated
09/28/2010
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