| NPI | 1235642828 |
|---|---|
| Doing Business As | JESSICA M. CLARK, DDS |
| Entity Type | Organization |
| Authorized Contact | JESSICA MICHELLE CLARK Pediatric Dentist 757-467-7797 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 1223P0221X Dentist, Pediatric Dentistry (Licence: VA 04041414334) |
| Enumeration Date | 2017-11-06 |
| Last Update Date | 2017-11-06 |