Organization
CLARK FAMILY DENTISTRY
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT J. CLARK DDS (PRESIDENT)
(985) 624-5449
Entity
Organization
Contact information
Practice address
639 LOTUS DR N, MANDEVILLE, LA 70471-2926
(985) 624-5449
(985) 674-0393
Mailing address
639 LOTUS DR N, MANDEVILLE, LA 70471-2926
(985) 624-5449
(985) 674-0393
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1495
LA
Other
Enumeration date
03/15/2007
Last updated
08/22/2020
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