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1174636419
BRENT WAYNE CLARK
FORT IRWIN, CA
NPI
1174636419
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
No
Primary Taxonomy
1223P0221X Dentist, Pediatric Dentistry
(Licence: KY 7735)
Enumeration Date
2006-08-17
Last Update Date
2023-06-29
Business Address
Dr. BRENT WAYNE CLARK DMD
390 NORTH LOOP RD.
FORT IRWIN, CA 92310
Phone number: 760-383-5289
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Mailing Address
Dr. BRENT WAYNE CLARK DMD
3935 BITTER SPRINGS DR
FORT IRWIN, CA 92310-1598
Phone number: 816-838-5663
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