Clark, Paul Kenneth
Clark, Paul Kenneth is an sole proprietor health care provider with primary practice located at 1502 Locust St N Ste 103 , Twin Falls ID 83301-6375. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Clark, Paul Kenneth can be contacted via phone (208) 831-2900.Contact Information
Primary practice address
1502 Locust St N Ste 103
Twin Falls ID 83301-6375
Phone: (208) 831-2900
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | D-5108-OS | Idaho |
| Dental Providers / Oral and Maxillofacial Surgery | 1223S0112X | 7829973-9922 | Utah |
Profile Details
| NPI number | 1689994923 |
|---|---|
| LBN Legal business name | Clark, Paul Kenneth |
| Credentials | D.M.D, M.D. |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 9th, 2010 |
| Last updated | Nov 15th, 2022 - about 2 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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