Individual
DR. RAYMOND B CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S
Contact information
Practice address
1520 HORTON RD, JACKSON, MI 49203-5127
(517) 784-2061
(517) 784-2115
Mailing address
1520 HORTON RD, JACKSON, MI 49203-5127
(517) 784-2061
(517) 784-2115
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
016724
MI
Other
Enumeration date
03/06/2007
Last updated
07/08/2007
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