Individual
DR. JULIETTE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
9500 EUCLID AVE # A-70, CLEVELAND, OH 44195-3019
(216) 444-2200
Mailing address
9500 EUCLID AVE # A-70, CLEVELAND, OH 44195-0001
(216) 444-2200
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
055358
NY
122300000X
Dentist
30.026991
OH
1223G0001X
General Practice Dentistry
Primary
10456
CT
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
004011136
—
CT
05
—
004236354
—
CT
Enumeration date
07/01/2009
Last updated
01/18/2023
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