Clark, Jason Drew

Clark, Jason Drew is an individual health care provider with primary practice located at 7810 Providence Rd Suite 100, Charlotte NC 28226-2987. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Clark, Jason Drew can be contacted via phone (704) 543-3766.

Contact Information

Primary practice address
7810 Providence Rd Suite 100 Charlotte NC 28226-2987
Phone: (704) 543-3766
Fax: (704) 543-3768
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 6966 North Carolina

Profile Details

NPI number 1346201431
LBN Legal business name Clark, Jason Drew
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 29th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1346201431 NPPES
North Carolina MEDICAID 8990141

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