Clark, Samantha Alexandria
Clark, Samantha Alexandria is an sole proprietor health care provider with primary practice located at 5 4Th Ave. E. , Polson MT 59860. She recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as her primary health care specialty. Clark, Samantha Alexandria can be contacted via phone (406) 745-3525.Contact Information
Primary practice address
5 4Th Ave. E.
Polson MT 59860
Phone: (406) 745-3525
Fax: (406) 745-3529
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 390200000 | Indiana |
| Dental Providers / Pediatric Dentistry | 1223P0221X | 12012102A | Indiana |
Profile Details
| NPI number | 1174967277 |
|---|---|
| LBN Legal business name | Clark, Samantha Alexandria |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Apr 19th, 2013 |
| Last updated | Sep 10th, 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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