| John Nicholas Clark D.d.s., Pa | |
|
810 Locust St Conway AR 72034-5331 | |
| (501) 327-4589 | |
| Not Available |
| Full Name | John Nicholas Clark D.d.s., Pa |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 810 Locust St, Conway, Arkansas |
| Authorized Official Name and Position | John Nicholas Clark (PRESIDENT) |
| Authorized Official Contact | 4794663834 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John Nicholas Clark D.d.s., Pa 810 Locust St Conway AR 72034-5331 Ph: (501) 327-4589 | John Nicholas Clark D.d.s., Pa 810 Locust St Conway AR 72034-5331 Ph: (501) 327-4589 |
| NPI Number | 1992056998 |
|---|---|
| Provider Enumeration Date | 10/01/2012 |
| Last Update Date | 10/01/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992056998 | NPI | - | NPPES |
| 187121608 | Medicaid | AR |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 3810 (Arkansas) | Primary |
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