DR. DDS Jeffrey M Clark, NPI 1649261850
Oral and Maxillofacial Surgery (Dentist) in Bowling Green, KY, US
NPI number: what is it?
The NPI, or National Provider Identifier, is a non-repeatable number for health care providers. The NPI always consists of 10 digits and is used for administrative and financial procedures. The NPI wa...
| NPI | 1649261850 |
| NPI Entity Type | Individual |
| Provider Name | DR. DDS Jeffrey M Clark |
| Enumeration Date | September 30, 2009 |
| Last Update Date | September 30, 2009 |
| Certification Date | September 30, 2009 |
| Provider Location Address | 1802 Rockingham Ave, Bowling Green, KY, US |
| Provider Mailing Address | 1802 Rockingham Ave, Bowling Green, KY, US, 421043348 |
| Gender | Male |
| Is Sole Proprietor? | Yes |
Primary Taxonomy
| Taxonomy Code | |
| Taxonomy Name | Oral and Maxillofacial Surgery (Dentist) |
| Classification | |
| Group | |
| License No. | 8960 |
| License State | KY |
| Description | 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. |
Secondary Taxonomies
| Taxonomy Code | Group | Classification | License No. | State | Primary? |
|---|---|---|---|---|---|
| 8960 | KY | No |
Other Identifiers
| Identifier | Identifier State | Identifier Issuer | Type/Code |
|---|---|---|---|
| 3146210 | TN | BCBS TN | 01 |
| 132568 | TRICARE | 01 | |
| 702005606 | TN | CARITEN COMMERICAL INSURA | 01 |
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