Individual
DR. DANIEL DEE CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1001 W BROADWAY, SUITE D AND E, FARMINGTON, NM 87401-5638
(505) 325-9133
Mailing address
4104 N BUENA VISTA AVE, FARMINGTON, NM 87401-2374
(214) 793-7256
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DD3904
NM
Other
Enumeration date
04/03/2013
Last updated
02/25/2015
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