| NPI | 1811462120 |
|---|---|
| Former Legal Business Name | DR ALBERT CLARK DDS PC |
| Entity Type | Organization |
| Authorized Contact | QUINN J SCHIFFMAN Owner/Member 801-375-1750 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2018-10-12 |
| Last Update Date | 2018-10-12 |