Clark, Stephen Jeter
Clark, Stephen Jeter is an sole proprietor health care provider with primary practice located at University Of Louisville School Of Dentistry 501 S. Preston St., Louisville KY 40292-0001. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Clark, Stephen Jeter can be contacted via phone (502) 852-5128.Contact Information
Primary practice address
University Of Louisville School Of Dentistry 501 S. Preston St.
Louisville KY 40292-0001
Phone: (502) 852-5128
Fax: (502) 852-7163
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 4107 | Kentucky |
Profile Details
| NPI number | 1386747400 |
|---|---|
| LBN Legal business name | Clark, Stephen Jeter |
| Credentials | Doctor of Dental Medicine (DMD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Sep 6th, 2006 |
| Last updated | Jul 8th, 2007 - 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1386747400 | NPPES |
| Kansas | MEDICAID | 60041076 |
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