Organization
CLARK DENTAL CARE INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KAMAL ABDEL BASIR ABDEL WAHAB DDS (PRESIDENT)
(937) 342-5370
Entity
Organization
Contact information
Practice address
1980 A KINGS GATE RD, SUITE A, SPRINGFIELD, OH 45502
(937) 342-5370
Mailing address
PO BOX 655, URBANA, OH 43078
(937) 342-5370
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0679565
—
OH
Enumeration date
01/11/2007
Last updated
08/22/2020
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