Edford Leon Clark in Prestonsburg - Dentist
Edford Leon Clark - NPI 1710927785
Edford Leon Clark is a Dentist in Prestonsburg, Kentucky. Edford Leon Clark practices all healthcare services and medical treatments related to Dentist. The NPI Number for Edford Leon Clark is 1710927785. The last update date is 2012-12-10.
Edford Leon Clark's current location address is 415 North Lake Drive, Prestonsburg, Kentucky. You can contact this provider via phone number 6068864260 and fax number 6068860886. The mailing address for Edford Leon Clark is 415 North Lake Drive, Prestonsburg, Kentucky. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Edford Leon Clark |
|---|---|
| Address | 415 North Lake Drive, Prestonsburg, Kentucky |
| Phone Number | 6068864260 |
| Fax Number | 6068860886 |
| Sole Proprietor | Y |
| Credentials | DMD |
NPI Number Detail
| NPI Number | 1710927785 |
|---|---|
| Provider Enumeration Date | 2006-06-07 |
| Last Updated Date | 2012-12-10 |
Provider Mailing Address Detail
| Address | 415 North Lake Drive |
|---|---|
| City | Prestonsburg |
| State | Kentucky (KY) |
| Post Code | 41653 |
| Phone Number | 6068864260 |
| Fax Number | 6068860886 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 5490 |
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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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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 66083861 | BCBS OF AL | ||
| 322610 | TIEGEN BCBS | ||
| 3147483 | BCBS OF TN | ||
| 401559 | UNITED CONCORDIA | ||
| 6005L905 | KY | -- | |
| 143184 | VA | BCBS OF VA | |
| E914 | FEDERAL BCBS |
Post Comment/ Review Below
What is the unique identification code assigned to Edford Leon Clark by the Centers for Medicare & Medicaid Services?
The Edford Leon Clark has been issued the NPI (National Provider Identifier) 1710927785. This 10-digit code serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Edford Leon Clark's physical address?
The Edford Leon Clark is physically located at 415 North Lake Drive, in the city of Prestonsburg, KY, with the postal code 41653.
What is Edford Leon Clark's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Edford Leon Clark is Dentist, and the corresponding taxonomy classification code for this specialized field is 122300000X.
On what date was the 1710927785 assigned to Edford Leon Clark?
The Edford Leon Clark was issued its 1710927785 on 2006-06-07, which is the date when this unique identifier was assigned to the organization by the Centers for Medicare & Medicaid Services.
When was the Edford Leon Clark's information last updated?
The Edford Leon Clark's information was last updated on 2012-12-10.