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General NPI Number Information
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NPI Number | 1821220294
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Entity Type | Organization
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Legal Business Name | DOW CLARK DENTAL ASSOCIATES
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Dates
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Enumeration Date | 08/18/2009
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Last Update Date | 08/18/2009
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Provider Practice Location Address
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Address Line | 6188 OXON HILL RD SUITE 604
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City | OXON HILL
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State | MD
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Zip | 20745-3113
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Country | US
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Telephone | 301-686-1070
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Fax | 301-686-1072
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Provider Business Mailing Address
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Address Line | 6188 OXON HILL RD SUITE 604
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City | OXON HILL
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State | MD
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Zip | 20745-3113
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Country | US
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Telephone | 301-686-1070
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Fax | 301-686-1072
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Authorized Official
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Title or Position | LEAD DOCTOR
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Name | DR. FREDRICK DOUGLASS CLARK
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Credential | DDS
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Telephone | 301-686-1070
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number |
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License Number State |
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