Organization
W.A. CLARK, D.D.S., P.L.L.C.
Active
Other names
Clark Family Dental
Organization subpart
No
Provider details
NPI number
Authorized official
DR. WALEED AJAMU CLARK DDS (OWNER)
(202) 271-3096
Entity
Organization
Contact information
Practice address
1040 NE 36TH ST, OKLAHOMA CITY, OK 73111-5002
(405) 427-5405
Mailing address
612 BELLEMEADE ST, GREENSBORO, NC 27401-1903
(202) 271-3096
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6354
OK
Other
Enumeration date
03/04/2013
Last updated
03/04/2013
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