| Clark Oral & Facial Surgery | |
|
1502 Locust St N Ste 103 Twin Falls ID 83301-6375 | |
| (208) 831-2900 | |
| Not Available |
| Full Name | Clark Oral & Facial Surgery |
|---|---|
| Speciality | Dentist - Oral And Maxillofacial Surgery |
| Location | 1502 Locust St N Ste 103, Twin Falls, Idaho |
| Authorized Official Name and Position | Paul Clark (SURGEON, OWNER) |
| Authorized Official Contact | 5039276845 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Oral & Facial Surgery 1502 Locust St N Ste 103 Twin Falls ID 83301-6375 Ph: (208) 831-2900 | Clark Oral & Facial Surgery 1502 Locust St N Ste 103 Twin Falls ID 83301-6375 Ph: (208) 831-2900 |
| NPI Number | 1649040858 |
|---|---|
| Provider Enumeration Date | 01/08/2024 |
| Last Update Date | 01/08/2024 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649040858 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
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