MEDICARE: DR. STARLA D. CLARK D.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	17316	OH

General Provider Information

NPI Number	:	1093930281
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. STARLA D. CLARK D.D.S.

Provider Business Mailing Address
First Line	:	10475 MONTGOMERY RD
Second Line	:	SUITE 2E
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5201
Country	:	US
Telephone Number	:	513-984-0888
Fax Number	:	513-984-0411

Provider Business Practice Location Address
First Line	:	10475 MONTGOMERY RD
Second Line	:	SUITE 2E
City	:	CINCINNATI
State	:	OH
Zip	:	45242-5201
Country	:	US
Telephone Number	:	513-984-0888
Fax Number	:	513-984-0411

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/14/2007
Last Update Date	:	07/08/2007

Similar Medicare Providers

1558349472 — MR. JERRY P GAO DDS
Practice Location Address:

10475 MONTGOMERY RD , 2 J
CINCINNATI, OH
45242-5201

Practice Phone: 513-791-0030
Practice Fax: 513-791-0031

1538139423 — AHMED E. MOSTAFA MD
Practice Location Address:

10475 MONTGOMERY RD
CINCINNATI, OH
45242-5201

Practice Phone: 513-865-1690
Practice Fax: 513-865-1691

1255348082 — DR. MILES J BURKE M.D.
Practice Location Address:

10475 MONTGOMERY RD , SUITE 4F
CINCINNATI, OH
45242-5201

Practice Phone: 513-984-4949
Practice Fax: 513-794-7552

1467592113 — BETHESDA HOSPITAL INC
Practice Location Address:

10475 MONTGOMERY RD , SUITE 4G
CINCINNATI, OH
45242-5201

Practice Phone: 513-745-1639
Practice Fax:

1831216506 — TRIHEALTH PHYSICIAN INSTITUTE
Practice Location Address:

10475 MONTGOMERY RD , STE 1D
CINCINNATI, OH
45242-5201

Practice Phone: 513-865-1690
Practice Fax: 513-865-1691

1336442011 — DEBRA DIANNE POGUE MSN
Practice Location Address:

10475 MONTGOMERY RD , SUITE 1J
CINCINNATI, OH
45242-5201

Practice Phone: 513-791-5548
Practice Fax: 513-791-5549

Directions to “ DR. STARLA D. CLARK D.D.S.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.