Organization
DR. ALBERT CLARK DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ALBERT BAXTER CLARK DDS (PRESIDENT)
(801) 375-1750
Entity
Organization
Contact information
Practice address
1355 N UNIVERSITY AVE, SUITE 320, PROVO, UT 84604-2721
(801) 375-1750
(801) 375-6365
Mailing address
1355 N UNIVERSITY AVE, SUITE 320, PROVO, UT 84604-2721
(801) 375-1750
(801) 375-6365
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
139191-9922
UT
Other
Enumeration date
02/26/2008
Last updated
02/26/2008
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