Clark, Brian Edward

Clark, Brian Edward is an individual health care provider with primary practice located at 5544 Turney Rd , Garfield Hts OH 44125-3780. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Clark, Brian Edward can be contacted via phone (216) 581-8931.

Contact Information

Primary practice address
5544 Turney Rd Garfield Hts OH 44125-3780
Phone: (216) 581-8931
Fax: (216) 581-8931
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 15130 Ohio

Profile Details

NPI number 1083756274
LBN Legal business name Clark, Brian Edward
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 13th, 2007
Last updated Jul 8th, 2007 - about 17 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 1083756274 NPPES
Ohio MEDICAID 0310621

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