Clark, Michael V.

Clark, Michael V. is an individual health care provider with primary practice located at 6900 Yellowtail Rd Suite 100, Cheyenne WY 82009-6102. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Clark, Michael V. can be contacted via phone (307) 635-9251.

Contact Information

Primary practice address
6900 Yellowtail Rd Suite 100 Cheyenne WY 82009-6102
Phone: (307) 635-9251
Fax: (307) 635-9218
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 1108 Wyoming

Profile Details

NPI number 1386778520
LBN Legal business name Clark, Michael V.
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 16th, 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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Identifiers

StateTypeNumberIssuer
All States NPI 1386778520 NPPES
Wyoming MEDICAID 119846700

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