Clark, Jerry R
Clark, Jerry R is an sole proprietor health care provider with primary practice located at 1115 W Friendly Ave , Greensboro NC 27401-1844. He recently has only one registered license in Dental Providers / Orthodontics and Dentofacial Orthopedics, which is considered as his primary health care specialty. Clark, Jerry R can be contacted via phone (336) 273-2528.Contact Information
Primary practice address
1115 W Friendly Ave
Greensboro NC 27401-1844
Phone: (336) 273-2528
Fax: (336) 273-8038
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Orthodontics and Dentofacial Orthopedics | 1223X0400X | 3338 | Pennsylvania |
Profile Details
| NPI number | 1619203551 |
|---|---|
| LBN Legal business name | Clark, Jerry R |
| Credentials | DDS, MS |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 28th, 2009 |
| Last updated | Oct 28th, 2009 - about 15 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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