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1003220203
SHANE THOMAS CLARK
ALBUQUERQUE, NM
NPI
1003220203
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223E0200X Dentist, Endodontics
(Licence: NM DD4100)
Enumeration Date
2014-06-16
Last Update Date
2015-09-26
Business Address
Dr. SHANE THOMAS CLARK DMD
2800 COORS BLVD NW
ALBUQUERQUE, NM 87120-1204
Phone number: 505-352-1166
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Mailing Address
Dr. SHANE THOMAS CLARK DMD
8400 OAKLAND AVE NE
ALBUQUERQUE, NM 87122-2721
Phone number: 512-689-8382
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