Organization
DR. MIKE L. CLARK FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BETSY M WARD (OFFICE MANAGER)
(509) 575-0419
Entity
Organization
Contact information
Practice address
1012 S 40TH AVE, YAKIMA, WA 98908-3804
(509) 575-0419
(509) 966-6595
Mailing address
1012 S 40TH AVE, YAKIMA, WA 98908-3804
(509) 575-0419
(509) 966-6595
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
DE00010004
WA
Other
Enumeration date
04/08/2008
Last updated
04/08/2008
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