Individual
SHELLY KAY CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
211 W BELT LINE RD, NORTH SUITE, CEDAR HILL, TX 75104-2066
(972) 291-0111
Mailing address
211 W BELT LINE RD, NORTH SUITE, CEDAR HILL, TX 75104-2066
(972) 291-0111
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
18113
TX
Other
Enumeration date
10/04/2006
Last updated
07/08/2007
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