Organization
CLARK GENERAL DENTISTRY CENTER, P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. RODNEY KEITH CLARK DDS (PRESIDENT)
(478) 746-0046
Entity
Organization
Contact information
Practice address
1918 FORSYTH ST, MACON, GA 31201-1144
(478) 746-0046
(478) 746-0970
Mailing address
1918 FORSYTH ST, MACON, GA 31201-1144
(478) 746-0046
(478) 746-0970
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12507
GA
Other
Enumeration date
06/25/2012
Last updated
06/25/2012
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