KELLY CLARK

Dentist - General Practice

Active Individual
NPI: 1942379458

Practice Address

3737 E RTE 36
Decatur, IL 62521

Phone: (217) 423-2400

Specialties

Specialty Code Primary License
Dentist - General Practice 1223G0001X Yes 019026315 (IL)

Frequently Asked Questions

NPI 1942379458 is the National Provider Identifier for KELLY CLARK, a Dentist - General Practice provider located in Decatur, IL. This NPI was enumerated on November 7, 2006.
KELLY CLARK practices at 3737 E RTE 36, Decatur, IL 62521.

Quick Facts

NPI
1942379458
Type
Individual
Enumerated
Nov 7, 2006
Last Updated
Apr 21, 2010

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