| NPI | 1033578653 |
|---|---|
| Professional Name | MATTHEW MITCHELL CLARK |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: VA 0401417451) |
| Additional Taxonomies | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 10945) |
| Enumeration Date | 2016-02-11 |
| Last Update Date | 2021-08-27 |