Clark, Shane Thomas
Clark, Shane Thomas is an individual health care provider with primary practice located at 2800 Coors Blvd Nw , Albuquerque NM 87120-1204. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Clark, Shane Thomas can be contacted via phone (505) 352-1166.Contact Information
Primary practice address
2800 Coors Blvd Nw
Albuquerque NM 87120-1204
Phone: (505) 352-1166
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | DD4100 | New Mexico |
Profile Details
| NPI number | 1003220203 |
|---|---|
| LBN Legal business name | Clark, Shane Thomas |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jun 16th, 2014 |
| Last updated | Sep 26th, 2015 - about 9 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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