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Individual

DR. TRACY MANNING CLARK

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D. S.

Contact information

Practice address
1500 S DAIRY ASHFORD RD, STE. 114, HOUSTON, TX 77077-3854
(281) 558-3440
(281) 558-3448
Mailing address
1500 S DAIRY ASHFORD RD, STE. 114, HOUSTON, TX 77077-3854
(281) 558-3440
(281) 558-3448

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
15603
TX

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
760367302
DENTAL
Enumeration date
02/26/2015
Last updated
02/26/2015
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