Clark, Jennifer M

Clark, Jennifer M is an individual health care provider with primary practice located at 4915 Washington Ave Ste B , Racine WI 53406-4221. She recently has only one registered license in Dental Providers / Dental Hygienist, which is considered as her primary health care specialty. Clark, Jennifer M can be contacted via phone (262) 619-1949.

Contact Information

Primary practice address
4915 Washington Ave Ste B Racine WI 53406-4221
Phone: (262) 619-1949
Fax: (877) 335-3684
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Dental Hygienist 124Q00000X 11479-16 Wisconsin

Profile Details

NPI number 1972976793
LBN Legal business name Clark, Jennifer M
Credentials Registered Dental Hygienist (RDH)
Entity Individual
Sole proprietor 1 No
Enumeration date Nov 2nd, 2015
Last updated Nov 2nd, 2015 - about 10 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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