Organization
CLARK & OTERO DDS PLLC
Active
Other names
Oak Grove Dental, Dental Center at Zebulon
Organization subpart
No
Provider details
NPI number
Authorized official
BEBE JACKSON (OFFICE MANAGER)
(910) 863-2377
Entity
Organization
Contact information
Practice address
103 GANYARD FARM WAY, DURHAM, NC 27703-6230
(919) 957-2444
(888) 505-9592
Mailing address
103 GANYARD FARM WAY, DURHAM, NC 27703-6230
(919) 957-2444
(888) 505-9592
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
7917
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
5903289
—
NC
Enumeration date
12/01/2008
Last updated
07/21/2022
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