| Clark Dentistry, Professional Corporation | |
|
330 Park Ave #10 Laguna Beach CA 92651-2352 | |
| (949) 494-1445 | |
| (949) 494-1215 |
| Full Name | Clark Dentistry, Professional Corporation |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 330 Park Ave, Laguna Beach, California |
| Authorized Official Name and Position | William B Clark (PRESIDENT) |
| Authorized Official Contact | 9494941445 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Dentistry, Professional Corporation 330 Park Ave #10 Laguna Beach CA 92651-2352 Ph: (949) 494-1445 | Clark Dentistry, Professional Corporation 330 Park Ave #10 Laguna Beach CA 92651-2352 Ph: (949) 494-1445 |
| NPI Number | 1275737405 |
|---|---|
| Provider Enumeration Date | 06/12/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275737405 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 32453 (California) | Primary |
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