Individual provider · Type 1 NPI

Adam Tanner Clark, DDS

Oral and Maxillofacial Surgery (Dentist) · Phoenix, AZ

NPI number 1366698490 Active

Practice location

706 E Bell Rd, Suite 106
Phoenix, AZ 85022-6640

Fax (602) 314-6497

Mailing address

3131 Pamela St
Prescott, AZ 86305-7153

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X7396 (AZ)
Oral and Maxillofacial Surgery (Dentist) 1223S0112X55257 (CA)

Oral and Maxillofacial Surgery (Dentist): 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.

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About NPI 1366698490

Adam Tanner Clark, DDS's National Provider Identifier is 1366698490, issued on Aug 8, 2008. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Phoenix, AZ. The record was last updated on Jun 4, 2010.