Individual
NORMAN CHARLES CLARK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D
Contact information
Practice address
4401 CONSHOHOCKEN AVE, SUITE 1, PHILADELPHIA, PA 19131-1553
(215) 877-9111
(215) 877-1524
Mailing address
4401 CONSHOHOCKEN AVE, SUITE 1, PHILADELPHIA, PA 19131-1553
(215) 877-9111
(215) 877-1524
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS0218962
PA
Other
Enumeration date
11/08/2007
Last updated
11/08/2007
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