Donald E. Clarke, D.D.S., INC.
Clinic/Center, Dental in Modesto, CA. Organization (NPI-2).
NPI number1104156744
StatusActive
Last updated in NPPESJan 4, 2010
Details
- NPI
- 1104156744
- Entity type
- Organization (NPI-2)
- Legal business name
- Donald E. Clarke, D.D.S., INC.
- Organization subpart
- No
- Enumeration date
- Jan 4, 2010
- Last updated
- Jan 4, 2010
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | – | – | Yes |
Other names
- Dental Source Of California (Doing Business As)
Practice location
1015 5th StModesto, CA 95351-2810
Phone 209-577-4263 · Fax 209-577-2056
Mailing address
1015 5th StModesto, CA 95351-2810
Phone 209-577-4263 · Fax 209-577-2056
Authorized official
Donald Clarke
Corporation President
9164870117
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