Organization
DONALD E. CLARKE, D.D.S., INC.
Active
Other names
Dental Source of California
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DONALD CLARKE D.D.S. (CORPOATION PRESIDENT)
(916) 487-0117
Entity
Organization
Contact information
Practice address
2200 PROFESSIONAL DR, SUITE 210, ROSEVILLE, CA 95661-7763
(916) 786-6157
(916) 786-0783
Mailing address
2200 PROFESSIONAL DR, SUITE 210, ROSEVILLE, CA 95661-7763
(916) 786-6157
(916) 786-0783
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
33738
CA
Other
Enumeration date
08/24/2006
Last updated
01/04/2010
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