NPI 1083840342

Jack R Clark, DMD

Practitioner General Practice Dentistry Homewood, AL

Practice location

Address: 1856 Lancaster Rd, Homewood, AL 35209-4114
Phone: (205) 871-2591
Fax: (205) 879-1900

Registered specialties

General Practice Dentistry Primary

Dental Providers Taxonomy 1223G0001X Licence 4290 (AL)

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Registry record

NPI: 1083840342
Entity type: Individual
Sex (as registered): Male
NPI issued: 1 Jun 2009
Record last updated: 1 Jun 2009

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.