Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. BRENT WAYNE CLARK, DMD
ActiveDR. BRENT WAYNE CLARK, DMD is a Pediatric Dentistry healthcare provider located in WIESBADEN, New York. NPI 1174636419 is currently active in the NPPES registry. Verify at CMS.
Pediatric Dentistry · WIESBADEN, NY
Registration Details
- NPI Number
- 1174636419
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 17, 2006 (19.982407279319 yrs)
- Last Updated
- Jul 10, 2025
- License
-
14192587-9926 (UT)
Practice Information
- Address
-
FLUGPLATZ ERBENHEIM 1040WIESBADEN, NY, 65205Browse NY providers · Browse ZIP 65205
- Phone
- 3145901515
- Primary Specialty
-
Pediatric Dentistry
1223P0221X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.