Clark, Brent Wayne

Clark, Brent Wayne is an individual health care provider with primary practice located at 390 North Loop Rd. , Fort Irwin CA 92310. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Clark, Brent Wayne can be contacted via phone (760) 383-5289.

Contact Information

Primary practice address
390 North Loop Rd. Fort Irwin CA 92310
Phone: (760) 383-5289
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 7735 Kentucky

Profile Details

NPI number 1174636419
LBN Legal business name Clark, Brent Wayne
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Aug 17th, 2006
Last updated Jun 29th, 2023 - about 2 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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