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1780753053
JAMES ROBERT CLARK
GLEN ALLEN, VA
NPI
1780753053
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Entity Type
Individual
Gender
Male
Sole Proprietor ?
Yes
Primary Taxonomy
122300000X Dentist
(Licence: VA 0401007316)
Enumeration Date
2006-11-08
Last Update Date
2007-07-08
Business Address
JAMES ROBERT CLARK
12413 FREMONT DR
GLEN ALLEN, VA 23059-6995
Phone number: 804-364-1170
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Mailing Address
JAMES ROBERT CLARK
12413 FREMONT DR
GLEN ALLEN, VA 23059-6995
Phone number: 804-364-1170
Copy
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