Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
DR. ROBERT WALLACE CLARK JR., D.D.S.
Active Sole ProprietorDR. ROBERT WALLACE CLARK JR., D.D.S. is a Dentist healthcare provider located in YOUNGTOWN, Arizona. NPI 1558420638 is currently active in the NPPES registry. Verify at CMS.
Dentist · YOUNGTOWN, AZ
Registration Details
- NPI Number
- 1558420638
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Dec 6, 2006 (19.686774303228 yrs)
- Last Updated
- Jul 8, 2007
- License
-
AZ2129 (AZ)
- Sole Proprietor
- Yes
Practice Information
- Address
-
11169 W ALABAMA AVEYOUNGTOWN, AZ, 853631228Browse AZ providers · Browse ZIP 85363
- Phone
- 6239332971
- Fax
- 6239724420
- Primary Specialty
-
Dentist
122300000X
Other Dentist Providers in YOUNGTOWN, AZ
| Name | Credential | NPI |
|---|---|---|
| MR. MARK PAUL YATES | DMD | 1194783886 |
| DR. LAURA NICHOLS | DMD, MHS-HIA | 1295010007 |
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.