DR. Robert Wallace Clark JR., D.D.S.

NPI #1558420638 in Youngtown, Arizona

Provider Information

NPI Number: 1558420638
Entity Type: Individual
Name: DR. Robert Wallace Clark JR., D.D.S.
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Credential: D.D.S.
Enumeration Date: Dec 6, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 11169 W ALABAMA AVE
City: Youngtown
State: Arizona
ZIP Code: 85363-1228
Phone: (623) 933-2971

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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