Adam Tanner Clark in Prescott - Oral And Maxillofacial Surgery
Adam Tanner Clark - NPI 1366698490
Adam Tanner Clark is a Oral And Maxillofacial Surgery in Prescott, Arizona. Adam Tanner Clark practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Adam Tanner Clark is 1366698490. The last update date is 2010-06-04.
Adam Tanner Clark's current location address is 3131 Pamela St, Prescott, Arizona. You can contact this provider via phone number 9095226392. The mailing address for Adam Tanner Clark is 3131 Pamela St, Prescott, Arizona. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Adam Tanner Clark |
|---|---|
| Address | 3131 Pamela St, Prescott, Arizona |
| Phone Number | 9095226392 |
| Fax Number | |
| Sole Proprietor | N |
| Credentials | DDS |
NPI Number Detail
| NPI Number | 1366698490 |
|---|---|
| Provider Enumeration Date | 2008-08-08 |
| Last Updated Date | 2010-06-04 |
Provider Mailing Address Detail
| Address | 3131 Pamela St |
|---|---|
| City | Prescott |
| State | Arizona (AZ) |
| Post Code | 863057153 |
| Phone Number | 9095226392 |
| Fax Number |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 7396 |
|
Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| 7396 | AZ | DENTAL LICENSE | |
| 55257 | CA | STATE LICENSE |
Post Comment/ Review Below
What is the unique 10-digit identification code assigned to Adam Tanner Clark by the Centers for Medicare & Medicaid Services?
The Adam Tanner Clark has been issued the NPI (National Provider Identifier) 1366698490, which serves as a unique identifier for healthcare providers, assigned by the Centers for Medicare & Medicaid Services (CMS).
Can you provide the Adam Tanner Clark's physical address?
The Adam Tanner Clark is physically located at 3131 Pamela St, in the city of Prescott, AZ, with the postal code 863057153.
What is Adam Tanner 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 Adam Tanner Clark is Oral And Maxillofacial Surgery, and the taxonomy classification code that categorizes this area of expertise is 1223S0112X.
When was the Adam Tanner Clark's 1366698490 issued?
The Adam Tanner Clark's 1366698490 was issued on 2008-08-08.
As of what date was the information regarding Adam Tanner Clark, such as address, specialty, and other details, last verified and confirmed to be up-to-date?
The information related to Adam Tanner Clark, including its address, specialty, and other relevant details, was last verified and confirmed to be up-to-date on 2010-06-04.
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