MR. Dennis Jay Clark JR., PA C

NPI #1750364188 in Groveton, Texas

Provider Information

NPI Number: 1750364188
Entity Type: Individual
Name: MR. Dennis Jay Clark JR., PA C
Gender: Not Specified
Sole Proprietor: No
Primary Specialty: Physician Assistant
Credential: PA C
Enumeration Date: Nov 21, 2005
Last Updated: Jul 28, 2010

Practice Location

Address: 110 MAGEE
City: Groveton
State: Texas
ZIP Code: 75845-4185
Phone: (936) 642-0841

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Physician Assistant	363A00000X	Primary

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