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1144321936
THEODORE GLENN CLARK
WINSTON-SALEM, NC
NPI
1144321936
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
122300000X Dentist
(Licence: NC 6127)
Enumeration Date
2006-09-26
Last Update Date
2007-07-08
Business Address
Dr. THEODORE GLENN CLARK DDS
3165 MAPLEWOOD AVENUE
WINSTON-SALEM, NC 27103
Phone number: 336-765-8358
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Mailing Address
Dr. THEODORE GLENN CLARK DDS
3165 MAPLEWOOD AVENUE
WINSTON-SALEM, NC 27103
Phone number: 336-765-8358
Copy
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