Dr. Mike L. Clark Family Dentistry
Clinic/Center, Dental in Yakima, WA. Organization (NPI-2).
NPI number1760655005
StatusActive
Last updated in NPPESApr 8, 2008
Details
- NPI
- 1760655005
- Entity type
- Organization (NPI-2)
- Legal business name
- Dr. Mike L. Clark Family Dentistry
- Organization subpart
- No
- Enumeration date
- Apr 8, 2008
- Last updated
- Apr 8, 2008
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 261QD0000X | Clinic/Center, Dental | DE00010004 | WA | Yes |
Practice location
1012 S 40th AveYakima, WA 98908-3804
Phone 509-575-0419 · Fax 509-966-6595
Mailing address
1012 S 40th AveYakima, WA 98908-3804
Phone 509-575-0419 · Fax 509-966-6595
Authorized official
Betsy M Ward
Office Manager
5095750419
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