| Dr. Albert Clark DDS, PC | |
|
1355 N University Ave Suite 320 Provo UT 84604-2721 | |
| (801) 375-1750 | |
| (801) 375-6365 |
| Full Name | Dr. Albert Clark DDS, PC |
|---|---|
| Speciality | Dentist |
| Location | 1355 N University Ave, Provo, Utah |
| Authorized Official Name and Position | Albert Baxter Clark (PRESIDENT) |
| Authorized Official Contact | 8013751750 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. Albert Clark DDS, PC 1355 N University Ave Suite 320 Provo UT 84604-2721 Ph: (801) 375-1750 | Dr. Albert Clark DDS, PC 1355 N University Ave Suite 320 Provo UT 84604-2721 Ph: (801) 375-1750 |
| NPI Number | 1972772853 |
|---|---|
| Provider Enumeration Date | 02/26/2008 |
| Last Update Date | 02/26/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1972772853 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 139191-9922 (Utah) | Primary |
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