| Tyler D. Clark DMD, PC | |
|
27 W 17th Ave Eugene OR 97401-4012 | |
| (541) 344-0413 | |
| (541) 344-3657 |
| Full Name | Tyler D. Clark DMD, PC |
|---|---|
| Speciality | Dentist |
| Location | 27 W 17th Ave, Eugene, Oregon |
| Authorized Official Name and Position | Tyler D Clark (OWNER) |
| Authorized Official Contact | 5413440413 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tyler D. Clark DMD, PC 27 W 17th Ave Eugene OR 97401-4012 Ph: (541) 344-0413 | Tyler D. Clark DMD, PC 27 W 17th Ave Eugene OR 97401-4012 Ph: (541) 344-0413 |
| NPI Number | 1144709635 |
|---|---|
| Provider Enumeration Date | 08/07/2018 |
| Last Update Date | 08/07/2018 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1144709635 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | D9605 (Oregon) | Primary |
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