Clark Dental P.C.

LBN: Clark Dental P.C.
Clark Dental P.C. is an health care organization with primary practice located at 10597 S Beach Comber Way , South Jordan UT 84009-6132. The organization recently has only one registered license in Dental Providers / General Practice, which is considered as the primary health care specialty. Clark Dental P.C. can be contacted via phone (208) 317-8555, or through Clark, Tanner Mark via phone (208) 317-8555.

Contact Information

Primary practice address
10597 S Beach Comber Way South Jordan UT 84009-6132
Phone: (208) 317-8555
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Clark, Tanner Mark Doctor of Dental Medicine (DMD)
Phone: (208) 317-8555

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 9860439-9921 Utah

Profile Details

NPI number 1902321045
LBN Legal business name Clark Dental P.C.
DBA Doing business as
Authorized official Clark, Tanner Mark Doctor of Dental Medicine (DMD)
Entity Organization
Organization subpart 1 No
Enumeration date Aug 10th, 2017
Last updated Jul 21st, 2022 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1902321045 NPPES
Utah MEDICAID 3003062

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