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Individual

DR. CLARK JOSEPH GROVER

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
10 PINE CREST DR, LA GRANDE, OR 97850-1300
(541) 963-6625
Mailing address
10 PINE CREST DR, LA GRANDE, OR 97850-1300
(541) 963-6625

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D4225
OR

Other

Enumeration date
05/13/2009
Last updated
05/13/2009
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