| Kelly Clark, | |
|
3737 E Rte 36, Decatur, IL 62521-5028 | |
| (217) 423-2400 | |
| (217) 423-2460 |
| Full Name | Kelly Clark |
|---|---|
| Gender | Male |
| Speciality | Dentist - General Practice |
| Location | 3737 E Rte 36, Decatur, Illinois |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1942379458 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 019026315 (Illinois) | Primary |
| Mailing Address | Practice Location Address |
|---|---|
| Kelly Clark, 1710 Brentwood Dr, Mt Zion, IL 62549-1183 Ph: () - | Kelly Clark, 3737 E Rte 36, Decatur, IL 62521-5028 Ph: (217) 423-2400 |
Dr. Michael Anthony Hage, DDS, MS Dentist Medicare: Not Enrolled in Medicare Practice Location: 2727 N Oakland Ave, Suite 106, Decatur, IL 62526 Phone: 217-875-5010 | |
Dr. Ricky Dean Simms, DMD Dentist Medicare: Not Enrolled in Medicare Practice Location: 3250 N Woodford St, Decatur, IL 62526 Phone: 217-877-2628 | |
Dr. William Smythe Tener, D.D.S.,M.S. Dentist Medicare: Accepting Medicare Assignments Practice Location: 302 W Hay St Ste Ll115, Decatur, IL 62526 Phone: 217-875-4466 | |
Dr. Daniel J. Loban, DDS Dentist Medicare: Medicare Enrolled Practice Location: 301 W North St, Decatur, IL 62522 Phone: 217-423-2400 | |
Dr. Chad Andrew Corley, DMD Dentist Medicare: Medicare Enrolled Practice Location: 160 W Mckinley Ave, Decatur, IL 62526 Phone: 217-330-6217 Fax: 217-330-8079 | |
Youngtak Chi, DDS Dentist Medicare: Medicare Enrolled Practice Location: 141 E Pershing Rd, Decatur, IL 62526 Phone: 888-988-4066 | |
Dr. Natalie A Corley, DMD Dentist Medicare: Medicare Enrolled Practice Location: 160 W Mckinley Ave, Decatur, IL 62526 Phone: 217-330-6217 Fax: 217-330-8079 |