Stephen W Clark in Long Beach - Periodontics
Stephen W Clark - NPI 1447311725
Stephen W Clark is a Periodontics in Long Beach, California. Stephen W Clark practices all healthcare services and medical treatments related to Periodontics. The NPI Number for Stephen W Clark is 1447311725. The last update date is 2019-09-18.
Stephen W Clark's current location address is 5963 E Spring St, Long Beach, California. You can contact this provider via phone number 5624218401 and fax number 5624210523. The mailing address for Stephen W Clark is 5963 E Spring St, Long Beach, California. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Stephen W Clark |
|---|---|
| Address | 5963 E Spring St, Long Beach, California |
| Phone Number | 5624218401 |
| Fax Number | 5624210523 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1447311725 |
|---|---|
| Provider Enumeration Date | 2006-12-12 |
| Last Updated Date | 2019-09-18 |
Provider Mailing Address Detail
| Address | 5963 E Spring St |
|---|---|
| City | Long Beach |
| State | California (CA) |
| Post Code | 908083752 |
| Phone Number | 5624218401 |
| Fax Number | 5624210523 |
Provider's Primary Taxonomy Detail
| Speciality | Periodontics |
|---|---|
| Taxonomy | 1223P0300X |
| Licence No | 20995 |
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Definition: That specialty of dentistry which encompasses the prevention, diagnosis and treatment of diseases of the supporting and surrounding tissues of the teeth or their substitutes and the maintenance of the health, function and esthetics of these structure |
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What is the unique 10-digit identifier code assigned to Stephen W Clark by the Centers for Medicare & Medicaid Services?
The Stephen W Clark has been issued the NPI (National Provider Identifier) 1447311725 by the CMS (Centers for Medicare & Medicaid Services), which serves as a unique identification number for healthcare providers.
Where is the Stephen W Clark located?
The Stephen W Clark is located at 5963 E Spring St, Long Beach, CA 908083752.
What is Stephen W Clark's specialized field of practice, and what is the corresponding taxonomy classification code?
The Stephen W Clark's area of specialization is Periodontics, and the corresponding taxonomy code that categorizes this field of practice is 1223P0300X.
When was the Stephen W Clark's 1447311725 issued?
The Stephen W Clark's 1447311725 was issued on 2006-12-12.
When was the Stephen W Clark's information last updated?
The Stephen W Clark's information was last updated on 2019-09-18.