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1205843604
EDWARD MARK CLARK
CHEYENNE, WY
NPI
1205843604
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: WY 750)
Enumeration Date
2006-08-01
Last Update Date
2007-07-08
Business Address
-- EDWARD MARK CLARK DDS
5211 YELLOWSTONE RD STE # 1
CHEYENNE, WY 82009-4761
Phone number: 307-634-7633
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Mailing Address
-- EDWARD MARK CLARK DDS
5211 YELLOWSTONE RD STE # 1
CHEYENNE, WY 82009-4761
Phone number: 307-634-7633
Copy
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