Organization
DAKOTA B CLARK DMD LLC
Active
Other names
Jacksonville Comprehensive Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DAKOTA B CLARK DMD (OWNER)
(256) 435-2007
Entity
Organization
Contact information
Practice address
1450 1ST AVE SW, JACKSONVILLE, AL 36265-3329
(256) 435-2007
Mailing address
1450 1ST AVE SW, JACKSONVILLE, AL 36265-3329
(256) 435-2007
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
—
—
Other
Enumeration date
10/15/2020
Last updated
10/15/2020
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