Theodore Glenn Clark in Winston-salem - Dentist
Theodore Glenn Clark - NPI 1144321936
Theodore Glenn Clark is a Dentist in Winston-salem, North Carolina. Theodore Glenn Clark practices all healthcare services and medical treatments related to Dentist. The NPI Number for Theodore Glenn Clark is 1144321936. The last update date is 2007-07-08.
Theodore Glenn Clark's current location address is 3165 Maplewood Avenue, Winston-salem, North Carolina. You can contact this provider via phone number 3367658358 and fax number 3367741063. The mailing address for Theodore Glenn Clark is 3165 Maplewood Avenue, Winston-salem, North Carolina. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Theodore Glenn Clark |
|---|---|
| Address | 3165 Maplewood Avenue, Winston-salem, North Carolina |
| Phone Number | 3367658358 |
| Fax Number | 3367741063 |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1144321936 |
|---|---|
| Provider Enumeration Date | 2006-09-26 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 3165 Maplewood Avenue |
|---|---|
| City | Winston-salem |
| State | North Carolina (NC) |
| Post Code | 27103 |
| Phone Number | 3367658358 |
| Fax Number | 3367741063 |
Provider's Primary Taxonomy Detail
| Speciality | Dentist |
|---|---|
| Taxonomy | 122300000X |
| Licence No | 6127 |
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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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Post Comment/ Review Below
What is the unique identifier code issued to Theodore Glenn Clark by the Centers for Medicare & Medicaid Services?
The Theodore Glenn Clark has been assigned the NPI (National Provider Identifier) 1144321936. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you provide the complete address where Theodore Glenn Clark is physically located?
The Theodore Glenn Clark is situated at the following address: 3165 Maplewood Avenue, Winston-Salem, NC 27103.
What is Theodore Glenn Clark's primary area of medical expertise, and what taxonomy classification code corresponds to this specialized field?
The primary area of medical expertise for Theodore Glenn Clark is Dentist, and the corresponding taxonomy classification code for this specialized field is 122300000X.
On what date did the Theodore Glenn Clark receive its 1144321936 assignment from the Centers for Medicare & Medicaid Services?
The Theodore Glenn Clark was assigned its 1144321936 by the Centers for Medicare & Medicaid Services on 2006-09-26.
When was the information pertaining to Theodore Glenn Clark most recently updated or revised?
The details related to Theodore Glenn Clark, including its address, specialty, and other relevant information, were last updated or revised on 2007-07-08.