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1679841811
TANNER MARK CLARK
PHILADELPHIA, PA
NPI
1679841811
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
1223G0001X Dentist, General Practice
(Licence: PA DS038910)
Enumeration Date
2011-12-02
Last Update Date
2016-04-25
Business Address
Dr. TANNER MARK CLARK D.M.D.
2203 FITZWATER ST UNIT 1
PHILADELPHIA, PA 19146-1132
Phone number: 208-317-8555
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Mailing Address
Dr. TANNER MARK CLARK D.M.D.
2203 FITZWATER ST UNIT 1
PHILADELPHIA, PA 19146-1132
Phone number: 208-317-8555
Copy
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