| Shelly K. Clark, Dentistry For Children | |
|
4450 E Highway 287 Midlothian TX 76065-5576 | |
| (972) 723-0111 | |
| Not Available |
| Full Name | Shelly K. Clark, Dentistry For Children |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 4450 E Highway 287, Midlothian, Texas |
| Authorized Official Name and Position | Shelly Clark (OWNER) |
| Authorized Official Contact | 9722914281 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shelly K. Clark, Dentistry For Children 4450 E Highway 287 Midlothian TX 76065-5576 Ph: (972) 723-0111 | Shelly K. Clark, Dentistry For Children 4450 E Highway 287 Midlothian TX 76065-5576 Ph: (972) 723-0111 |
| NPI Number | 1821684929 |
|---|---|
| Provider Enumeration Date | 12/14/2020 |
| Last Update Date | 12/14/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1821684929 | NPI | - | NPPES |
| 210909202 | Medicaid | TX |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | (* (Not Available)) | Primary |
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