Individual
CLARK CHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
5855 E STILL CIR, MESA, AZ 85206-3631
(480) 219-6000
Mailing address
5855 E STILL CIR, MESA, AZ 85206-3631
Taxonomy
Speciality
Code
Description
License number
State
1223P0700X
Prosthodontics
Primary
61870
CA
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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