Clark, David Michael
Clark, David Michael is an sole proprietor health care provider with primary practice located at 799 Northern Blvd , South Abington Township PA 18411-9087. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Clark, David Michael can be contacted via phone (570) 586-1700.Contact Information
Primary practice address
799 Northern Blvd
South Abington Township PA 18411-9087
Phone: (570) 586-1700
Fax: (570) 586-1900
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DA 026947 A | Pennsylvania |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | DS 026947 L | Pennsylvania |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 046057-1 | New York |
Profile Details
| NPI number | 1619919685 |
|---|---|
| LBN Legal business name | Clark, David Michael |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 12th, 2006 |
| Last updated | Jan 7th, 2016 - about 8 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1619919685 | NPPES |
| Pennsylvania | MEDICAID | 1476589 |
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