Clark, Andrew Edward

Clark, Andrew Edward is an individual health care provider with primary practice located at 1036-42 Dunn Ave , Jacksonville FL 32218-6359. He recently has 2 registered licenses in different health care specialties including Student, Health Care / Student in an Organized Health Care Education/Training Program, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Clark, Andrew Edward can be contacted via phone (904) 714-9909.

Contact Information

Primary practice address
1036-42 Dunn Ave Jacksonville FL 32218-6359
Phone: (904) 714-9909
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Student, Health Care / Student in an Organized Health Care Education/Training Program 390200000X DN 19032 Florida
Dental Providers / Orthodontics and Dentofacial Orthopedics 1223X0400X DN 19032 Florida

Profile Details

NPI number 1992017164
LBN Legal business name Clark, Andrew Edward
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 5th, 2010
Last updated Jan 10th, 2013 - about 12 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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