Individual
DR. SHANNON CAROL CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
1411 S RANGE LINE RD, JOPLIN, MO 64801-5589
(417) 541-2666
Mailing address
1411 S RANGE LINE RD, JOPLIN, MO 64801-5589
(417) 541-2666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2020005163
MO
122300000X
Dentist
3142
AR
122300000X
Dentist
62065
KS
Other
Enumeration date
04/25/2008
Last updated
03/18/2026
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