Organization
DOW CLARK DENTAL ASSOCIATES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. FREDRICK DOUGLASS CLARK DDS (LEAD DOCTOR)
(301) 686-1070
Entity
Organization
Contact information
Practice address
6188 OXON HILL RD, SUITE 604, OXON HILL, MD 20745-3113
(301) 686-1070
(301) 686-1072
Mailing address
6188 OXON HILL RD, SUITE 604, OXON HILL, MD 20745-3113
(301) 686-1070
(301) 686-1072
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
05724244
—
MD
Enumeration date
08/18/2009
Last updated
08/18/2009
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