Individual
DR. THOMAS R CLARK
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
3410 W PURDUE AVE, MUNCIE, IN 47304-5267
(765) 747-9545
(765) 747-0727
Mailing address
3410 W PURDUE AVE, MUNCIE, IN 47304-5267
(765) 747-9545
(765) 747-0727
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007845
IN
Other
Enumeration date
01/18/2006
Last updated
07/08/2007
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