| NPI | 1679671986 |
|---|---|
| Former Legal Business Name | CLARK ORAL AND FACIAL SURGERY |
| Entity Type | Organization |
| Authorized Contact | HOWARD DANIEL CLARK Managing Partner 615-591-0919 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223S0112X Dentist, Oral and Maxillofacial Surgery (Licence: TN 8111) |
| Enumeration Date | 2006-09-20 |
| Last Update Date | 2016-11-18 |