Dr. Darrell Adrian Clark D.d.s.

NPI #1568681682 in Waldorf, Maryland

Provider Information

NPI Number: 1568681682
Entity Type: Organization
Organization Name: Dr. Darrell Adrian Clark D.d.s.
Primary Specialty: Dentist - Orthodontics and Dentofacial Orthopedics
Enumeration Date: Apr 25, 2007
Last Updated: Jul 12, 2011

Practice Location

Address: 12070 OLD LINE CTR
City: Waldorf
State: Maryland
ZIP Code: 20602-2513
Phone: (301) 638-0282

Authorized Official

Name: DR. DARRELL ADRIAN CLARK, D.D.S.
Title: PRESIDENT
Phone: (301) 512-0132

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - Orthodontics and Dentofacial Orthopedics — Orthodontics and Dentofacial Orthopedics	1223X0400X	Primary

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