NPI | 1619193216 |
---|---|
Doing Business As | CLARK FAMILY DENTISTRY |
Entity Type | Organization |
Authorized Contact | LEON MALCOLM CLARK President 256-350-8182 |
Organization Subpart ? | No |
Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: AL 4499) |
Enumeration Date | 2007-04-18 |
Last Update Date | 2020-08-22 |