James Robert Clark

NPI #1780753053 in Glen Allen, Virginia

Provider Information

NPI Number: 1780753053
Entity Type: Individual
Name: James Robert Clark
Gender: Not Specified
Sole Proprietor: Yes
Primary Specialty: Dentist
Enumeration Date: Nov 8, 2006
Last Updated: Jul 8, 2007

Practice Location

Address: 12413 FREMONT DR
City: Glen Allen
State: Virginia
ZIP Code: 23059-6995
Phone: (804) 364-1170

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist	122300000X	Primary

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