| John W. Clark Pa | |
|
753 Stillwater Ave Bangor ME 04401-3633 | |
| (207) 990-5887 | |
| (207) 307-7002 |
| Full Name | John W. Clark Pa |
|---|---|
| Speciality | Dentist |
| Location | 753 Stillwater Ave, Bangor, Maine |
| Authorized Official Name and Position | John Warren Clark (OWNER) |
| Authorized Official Contact | 2075648197 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| John W. Clark Pa 753 Stillwater Ave Bangor ME 04401-3633 Ph: (207) 990-5887 | John W. Clark Pa 753 Stillwater Ave Bangor ME 04401-3633 Ph: (207) 990-5887 |
| NPI Number | 1326306085 |
|---|---|
| Provider Enumeration Date | 05/01/2012 |
| Last Update Date | 12/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1326306085 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 3365 (Maine) | Primary |
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