Joel R. Clark is a Pediatric Dentistry in Mesa, Arizona. Joel R. Clark practices all healthcare services and medical treatments related to Pediatric Dentistry. The NPI Number for Joel R. Clark is 1790759439. The last update date is 2007-07-08.
Joel R. Clark's current location address is 1925 S Sossaman Rd, Mesa, Arizona. You can contact this provider via phone number 4805033764 and fax number 4803800336. The mailing address for Joel R. Clark is 1925 S Sossaman Rd, Mesa, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Joel R. Clark |
|---|---|
| Address | 1925 S Sossaman Rd, Mesa, Arizona |
| Phone Number | 4805033764 |
| Fax Number | 4803800336 |
| Sole Proprietor | X |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1790759439 |
|---|---|
| Provider Enumeration Date | 2006-02-16 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 1925 S Sossaman Rd |
|---|---|
| City | Mesa |
| State | Arizona (AZ) |
| Post Code | 852094275 |
| Phone Number | 4805033764 |
| Fax Number | 4803800336 |
Provider's Primary Taxonomy Detail
| Speciality | Pediatric Dentistry |
|---|---|
| Taxonomy | 1223P0221X |
| Licence No | 5179 |
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Definition: An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 713546 | AZ | -- |
Post Comment/ Review Below
What is the unique 10-digit identification code issued to Joel R. Clark by the Centers for Medicare & Medicaid Services?
The Joel R. Clark has been assigned the NPI (National Provider Identifier) 1790759439 by the Centers for Medicare & Medicaid Services (CMS). This 10-digit code serves as a unique identifier for healthcare providers.
Could you kindly provide the complete physical address where Joel R. Clark's facilities are geographically located?
The facilities of Joel R. Clark are physically situated at the following location: 1925 S Sossaman Rd, Mesa, AZ, 852094275.
What is Joel R. Clark's primary field of medical specialization, and what is the corresponding taxonomy classification code for this area of expertise?
The primary field of medical specialization for Joel R. Clark is Pediatric Dentistry, and the taxonomy classification code that categorizes this area of expertise is 1223P0221X.
On what date did the Joel R. Clark receive the assignment of its 1790759439 from the Centers for Medicare & Medicaid Services?
The Joel R. Clark was issued its 1790759439 by the Centers for Medicare & Medicaid Services on 2006-02-16.
When was the information regarding Joel R. Clark most recently updated?
The details pertaining to the Joel R. Clark, including its address, specialty, and other relevant information, were last refreshed on 2007-07-08.