Organization
JOHN S. CLARK, APDC
Active
Other names
Mississippi Orthodontic Specialists
Organization subpart
No
Provider details
NPI number
Authorized official
DR. JOHN S CLARK D.D.S. (PRESIDENT)
(228) 896-8355
Entity
Organization
Contact information
Practice address
411 SECURITY SQ, GULFPORT, MS 39507-1922
(228) 896-8355
Mailing address
411 SECURITY SQ, GULFPORT, MS 39507-1922
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
OR-050-82
MS
Other
Enumeration date
04/20/2007
Last updated
09/28/2010
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