| NPI | 1356133870 |
|---|---|
| Doing Business As | CLARK ORAL & FACIAL SURGERY, PC |
| Entity Type | Organization |
| Authorized Contact | DURELLA DEE HOLMES Practice Manager 208-831-2900 |
| Organization Subpart ? | Yes |
| Primary Taxonomy | 261QS0112X Clinic/Center, Oral and Maxillofacial Surgery |
| Enumeration Date | 2025-05-20 |
| Last Update Date | 2025-05-20 |