Individual
DR. MICHAEL EDWARD CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
403 E MCKAY ST, FRONTENAC, KS 66763-2244
(620) 231-1992
(620) 231-1525
Mailing address
403 E MCKAY ST, FRONTENAC, KS 66763-2244
(620) 231-1992
(620) 231-1525
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6842
KS
Other
Enumeration date
06/30/2006
Last updated
07/08/2007
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