| Clark Family Dental | |
|
1040 Ne 36th St Oklahoma City OK 73111-5002 | |
| (405) 427-5405 | |
| Not Available |
| Full Name | Clark Family Dental |
|---|---|
| Speciality | Dentist |
| Location | 1040 Ne 36th St, Oklahoma City, Oklahoma |
| Authorized Official Name and Position | Waleed Ajamu Clark (OWNER) |
| Authorized Official Contact | 2022713096 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Family Dental 612 Bellemeade St Greensboro NC 27401-1903 Ph: (202) 271-3096 | Clark Family Dental 1040 Ne 36th St Oklahoma City OK 73111-5002 Ph: (405) 427-5405 |
| NPI Number | 1740521509 |
|---|---|
| Provider Enumeration Date | 03/04/2013 |
| Last Update Date | 03/04/2013 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1740521509 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 6354 (Oklahoma) | Primary |
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