Clark General Dentistry Center, P.C.
Dentist in Macon, GA. Organization (NPI-2).
NPI number1740543776
StatusActive
Last updated in NPPESJun 25, 2012
Details
- NPI
- 1740543776
- Entity type
- Organization (NPI-2)
- Legal business name
- Clark General Dentistry Center, P.C.
- Organization subpart
- No
- Enumeration date
- Jun 25, 2012
- Last updated
- Jun 25, 2012
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 122300000X | Dentist | 12507 | GA | Yes |
Practice location
1918 Forsyth StMacon, GA 31201-1144
Phone 478-746-0046 · Fax 478-746-0970
Mailing address
1918 Forsyth StMacon, GA 31201-1144
Phone 478-746-0046 · Fax 478-746-0970
Authorized official
Rodney Keith Clark
President
4787460046
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All 41 Dentist providers in Macon · All 5,121 providers in Macon
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