Individual provider · NPI-1

David Stephen Clark, DDS

Dentist, General Practice · Muskogee, OK

NPI number1053832907
StatusActive
Last updated in NPPESJun 16, 2018

Details

NPI
1053832907
Entity type
Individual (NPI-1)
Name
David Stephen Clark
Credential
DDS
Sex
Male
Sole proprietor
No
Enumeration date
Jun 30, 2017
Last updated
Jun 16, 2018

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
1223G0001X Dentist, General Practice6977OKYes

Practice location

2909 Azalea Park Dr
Muskogee, OK 74401-2283

Phone 918-682-0544

Mailing address

5810 E Skelly Dr Ste 1800
Tulsa, OK 74135-6434

Phone 918-998-0996

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