Christoffersen, Clark Dale
Christoffersen, Clark Dale is an individual health care provider with primary practice located at 118 E Crawford , Deer Park WA 99006. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Christoffersen, Clark Dale can be contacted via phone (509) 276-2421.Contact Information
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DE00005057 | Washington |
Profile Details
| NPI number | 1558439174 |
|---|---|
| LBN Legal business name | Christoffersen, Clark Dale |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Dec 1st, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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 | 1558439174 | NPPES |
| Other | DE00005057 | DENTAL |
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