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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