| Clark Orthodontics, Inc. | |
|
650 W. Cherry St. Suite 5 North Liberty IA 52317 | |
| (319) 626-3161 | |
| Not Available |
| Full Name | Clark Orthodontics, Inc. |
|---|---|
| Speciality | Dentist - Orthodontics And Dentofacial Orthopedics |
| Location | 650 W. Cherry St., North Liberty, Iowa |
| Authorized Official Name and Position | Tanner Clark (PRESIDENT) |
| Authorized Official Contact | 3196263161 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clark Orthodontics, Inc. 650 W. Cherry St. Suite 5 North Liberty IA 52317 Ph: (319) 626-3161 | Clark Orthodontics, Inc. 650 W. Cherry St. Suite 5 North Liberty IA 52317 Ph: (319) 626-3161 |
| NPI Number | 1891083002 |
|---|---|
| Provider Enumeration Date | 07/21/2011 |
| Last Update Date | 01/27/2012 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1891083002 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223X0400X | Dentist - Orthodontics And Dentofacial Orthopedics | 08218 (Iowa) | Primary |
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