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Individual

DR. ANDREW EDWARD CLARK

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DMD

Contact information

Practice address
5555 ROANOKE TRAIL, TALLAHASSEE, FL 32312
(850) 385-2822
(850) 385-9476
Mailing address
5555 ROANOKE TRAIL, TALLAHASSEE, FL 32312
(850) 385-2822
(850) 385-9476

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DN 19032
FL
390200000X
Student in an Organized Health Care Education/Training Program
DN 19032
FL

Other

Enumeration date
07/05/2010
Last updated
04/24/2025
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