Individual
DR. ROBERT WALLACE CLARK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3666 N MILLER RD, SCOTTSDALE, AZ 85251-4599
(480) 994-9485
(480) 481-3800
Mailing address
3666 N MILLER RD, SCOTTSDALE, AZ 85251-4599
(480) 994-9485
(480) 481-3800
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6575
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
955940
AHCCCS
AZ
Enumeration date
09/02/2006
Last updated
07/08/2007
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