KELLY CLARK
Dentist - General Practice
Active
Individual
NPI: 1942379458
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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