| Dr. James L Clark, Dds | |
|
116 E 14th St Ada OK 74820-6518 | |
| (580) 279-5760 | |
| Not Available |
| Full Name | Dr. James L Clark, Dds |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 116 E 14th St, Ada, Oklahoma |
| Authorized Official Name and Position | Latisha Booth (OFFICE MANAGER) |
| Authorized Official Contact | 5802795760 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Dr. James L Clark, Dds Po Box 458 Ada OK 74821-0458 Ph: (580) 279-5760 | Dr. James L Clark, Dds 116 E 14th St Ada OK 74820-6518 Ph: (580) 279-5760 |
| NPI Number | 1831601657 |
|---|---|
| Provider Enumeration Date | 11/02/2017 |
| Last Update Date | 11/02/2017 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1831601657 | NPI | - | NPPES |
| 1720161326 | Other | OK | TEMP DENTIST |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 4245 (Oklahoma) | Primary |
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