Clark, Richard James

Clark, Richard James is an individual health care provider with primary practice located at 2300 Garrett Rd , Drexel Hill PA 19026-1102. He recently has 2 registered licenses in different health care specialties including Dental Providers / Oral and Maxillofacial Surgery, Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery. Dental Providers / Oral and Maxillofacial Surgery is his primary health care specialty. Clark, Richard James can be contacted via phone (610) 623-4211.

Contact Information

Primary practice address
2300 Garrett Rd Drexel Hill PA 19026-1102
Phone: (610) 623-4211
Fax: (610) 623-2850
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X DS024574L Pennsylvania
Allopathic & Osteopathic Physicians / Oral & Maxillofacial Surgery 204E00000X DS024574L Pennsylvania

Profile Details

NPI number 1942249545
LBN Legal business name Clark, Richard James
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 6th, 2006
Last updated Apr 22nd, 2008 - about 17 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 1942249545 NPPES
Pennsylvania MEDICAID 1172921

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