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General NPI Number Information
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NPI Number | 1932198694
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Entity Type | Individual
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Provider Name | H. DANIEL CLARK DDS, MD
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Gender | Male
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Dates
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Enumeration Date | 10/17/2005
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Last Update Date | 03/22/2013
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Provider Practice Location Address
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Address Line | 3000 STANSBERRY LN SUITE 101
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City | FRANKLIN
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State | TN
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Zip | 37069
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Country | US
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Telephone | 615-591-0919
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Fax | 615-599-6762
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Provider Business Mailing Address
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Address Line | 3000 STANSBERRY LN SUITE 101
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City | FRANKLIN
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State | TN
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Zip | 37069-5125
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Country | US
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Telephone | 615-591-0919
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Fax | 615-599-6762
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | DS0000008111
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 204E00000X
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Taxonomy Name | Oral & Maxillofacial Surgery (D.M.D.)
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License Number | MD0000037255
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License Number State | TN
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