Clark, Adam Tanner

Clark, Adam Tanner is an individual health care provider with primary practice located at 706 E Bell Rd Suite 106, Phoenix AZ 85022-6640. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Clark, Adam Tanner can be contacted via phone (602) 996-2600.

Contact Information

Primary practice address
706 E Bell Rd Suite 106 Phoenix AZ 85022-6640
Phone: (602) 996-2600
Fax: (602) 314-6497
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 7396 Arizona
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 55257 California

Profile Details

NPI number 1366698490
LBN Legal business name Clark, Adam Tanner
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 8th, 2008
Last updated Jun 4th, 2010 - about 14 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1366698490 NPPES
Arizona Other 7396 DENTAL LICENSE
Arizona Other 55257 DENTAL LICENSE

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