Charlie E Clark is a Dentist in Surprise, Arizona. Charlie E Clark practices all healthcare services and medical treatments related to Dentist. The NPI Number for Charlie E Clark is 1417103482. The last update date is 2009-08-04.
Charlie E Clark's current location address is 15264 W Brookside Ln, Surprise, Arizona. You can contact this provider via phone number 6234743975 and fax number 6234743198. The mailing address for Charlie E Clark is 15264 W Brookside Ln, Surprise, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Charlie E Clark |
|---|---|
| Address | 15264 W Brookside Ln, Surprise, Arizona |
| Phone Number | 6234743975 |
| Fax Number | 6234743198 |
| Sole Proprietor | N |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1417103482 |
|---|---|
| Provider Enumeration Date | 2008-08-11 |
| Last Updated Date | 2009-08-04 |
Provider Mailing Address Detail
| Address | 15264 W Brookside Ln |
|---|---|
| City | Surprise |
| State | Arizona (AZ) |
| Post Code | 853743989 |
| Phone Number | 6234743975 |
| Fax Number | 6234743198 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | D7793 |
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Definition: A dentist is a person qualified by a doctorate in dental surgery (D.D.S.) or dental medicine (D.M.D.), licensed by the state to practice dentistry, and practicing within the scope of that license. There is no difference between the two degrees: denti |
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What is the unique 10-digit identifier code assigned to Charlie E Clark by the Centers for Medicare & Medicaid Services?
The Charlie E Clark has been issued the NPI (National Provider Identifier) 1417103482 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Could you kindly provide the complete physical address where Charlie E Clark's facilities are geographically located?
The facilities of Charlie E Clark are physically situated at the following location: 15264 W Brookside Ln, Surprise, AZ, 853743989.
What is Charlie E Clark's specialized area of practice, and what is the corresponding taxonomy classification code for this field?
The Charlie E Clark's specialized field of practice is Dentist, and the corresponding taxonomy code that categorizes this area of specialization is 122300000X.
When did Charlie E Clark receive its 1417103482 assignment?
The Charlie E Clark was assigned its 1417103482 on 2008-08-11, which is the date when this unique identifier was issued to the organization.
When was the information regarding Charlie E Clark most recently updated?
The details pertaining to the Charlie E Clark, including its address, specialty, and other relevant information, were last refreshed on 2009-08-04.
NPI Number: 1336142389
Address: Po Box 2004, East Syracuse, NY