Individual
DR. JEFFREY DEAN CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
3310 FRANKLIN RD SW, ROANOKE, VA 24014-1310
(540) 342-7221
(540) 400-8304
Mailing address
3310 FRANKLIN RD SW, ROANOKE, VA 24014-1310
(540) 342-7221
(540) 400-8304
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
0401005866
VA
Other
Enumeration date
11/29/2006
Last updated
07/08/2007
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