Organization
R JOSEPH CLARK DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. R JOSEPH CLARK DDS (PRESIDENT)
(812) 522-7360
Entity
Organization
Contact information
Practice address
500 N CHESTNUT ST, SEYMOUR, IN 47274
(812) 522-7360
Mailing address
PO BOX 684, SEYMOUR, IN 47274
(812) 522-7360
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12005390A
IN
Other
Enumeration date
02/12/2007
Last updated
08/22/2020
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