Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. CHARLIE E CLARK, DMD
ActiveDR. CHARLIE E CLARK, DMD is a Dentist healthcare provider located in SURPRISE, Arizona. NPI 1417103482 is currently active in the NPPES registry. Verify at CMS.
Dentist · SURPRISE, AZ
Registration Details
- NPI Number
- 1417103482
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 11, 2008 (18.000183530761 yrs)
- Last Updated
- Aug 4, 2009
- Licenses
-
D7793 (AZ)6303-15 (WI)
Practice Information
- Address
-
15264 W BROOKSIDE LNSURPRISE, AZ, 853743989Browse AZ providers · Browse ZIP 85374
- Phone
- 6234743975
- Fax
- 6234743198
- Primary Specialty
-
Dentist
122300000X
- Additional Specialty
- Dentist
Other Dentist Providers in SURPRISE, AZ
| Name | Credential | NPI |
|---|---|---|
| DR. STEPHEN P. MURRELL | DDS | 1306825427 |
| MRS. ROSA MARIA KRASAVAGE | DDS | 1962462705 |
| DR. KIMBERLY JEAN FULTON | D.M.D. | 1528092863 |
| DR. JOHN Y. KIM | D.D.S. | 1902986250 |
| DR. SOPHIE REJEANNE ADAM | D.M.D. | 1841412798 |
| STEPHANIE MASHNI | DDS | 1730355041 |
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.