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Individual

KATHERINE ANNE CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
DDS

Contact information

Practice address
2246 JACKSBORO HWY STE 112, FORT WORTH, TX 76114-2363
(817) 529-1799
Mailing address
101 E GLADE RD APT 9201, GRAPEVINE, TX 76051-7392
(225) 241-2856

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
41822
TX

Other

Enumeration date
08/06/2025
Last updated
08/06/2025
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