Clark, Jeffry Stephen

Clark, Jeffry Stephen is an individual health care provider with primary practice located at 1950 Roland Clarke Pl 420, Reston VA 20191-1414. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Clark, Jeffry Stephen can be contacted via phone (703) 391-2600.

Contact Information

Primary practice address
1950 Roland Clarke Pl 420 Reston VA 20191-1414
Phone: (703) 391-2600
Fax: (703) 391-2097
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dentist 122300000X 0401008224 Virginia

Profile Details

NPI number 1790821429
LBN Legal business name Clark, Jeffry Stephen
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jan 29th, 2007
Last updated Jul 8th, 2007 - about 18 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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