DR. Shane Thomas Clark, DMD

NPI #1003220203 in Albuquerque, New Mexico

Provider Information

NPI Number: 1003220203
Entity Type: Individual
Name: DR. Shane Thomas Clark, DMD
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Dentist - Endodontics
Credential: DMD
Enumeration Date: Jun 16, 2014
Last Updated: Sep 26, 2015

Practice Location

Address: 2800 COORS BLVD NW
City: Albuquerque
State: New Mexico
ZIP Code: 87120-1204
Phone: (505) 352-1166

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Endodontics — Endodontics	1223E0200X	Primary

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