Clark, Candice Ella
Clark, Candice Ella is an individual health care provider with primary practice located at 506 Airport Dr , Farmington NM 87401-2602. She recently has only one registered license in Dental Providers / General Practice, which is considered as her primary health care specialty. Clark, Candice Ella can be contacted via phone (505) 325-7700.Contact Information
Primary practice address
506 Airport Dr
Farmington NM 87401-2602
Phone: (505) 325-7700
Fax: (505) 327-5710
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / General Practice | 1223G0001X | DD2673 | New Mexico |
Profile Details
| NPI number | 1124018379 |
|---|---|
| LBN Legal business name | Clark, Candice Ella |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 27th, 2005 |
| 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.
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