Clark, Benjamin Todd
Clark, Benjamin Todd is an individual health care provider with primary practice located at 1100 Wilford Hall Loop Bldg 4554 , Jbsa Lackland TX 78236-5638. He recently has 2 registered licenses in different health care specialties including Dental Providers / General Practice, Dental Providers / Orthodontics and Dentofacial Orthopedics. Dental Providers / Orthodontics and Dentofacial Orthopedics is his primary health care specialty. Clark, Benjamin Todd can be contacted via phone (210) 292-8629.Contact Information
Primary practice address
1100 Wilford Hall Loop Bldg 4554
Jbsa Lackland TX 78236-5638
Phone: (210) 292-8629
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | 8412 | Tennessee |
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 24280 | Texas |
Profile Details
| NPI number | 1598743627 |
|---|---|
| LBN Legal business name | Clark, Benjamin Todd |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 9th, 2006 |
| Last updated | Aug 17th, 2023 - about last year |
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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