Individual provider · Type 1 NPI
Clark U. Knowlton, DDS
Orthodontics and Dentofacial Orthopedics Dentistry · Meridian, ID
Practice location
543 W Gable St
Meridian, ID 83646-6355
Mailing address
111 E 210th St
Bronx, NY 10467-2401
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Dentist | 122300000X | DD5108 (NM) |
| Student in an Organized Health Care Education/Training Program | 390200000X | None listed |
| Orthodontics and Dentofacial Orthopedics Dentistry Primary | 1223X0400X | D-5193-OR (ID) |
Orthodontics and Dentofacial Orthopedics Dentistry: That area of dentistry concerned with the supervision, guidance and correction of the growing or mature dentofacial structures, including those conditions that require movement of teeth or correction of malrelationships and malformations of their related structures and the adjustment of relationships between and among teeth and facial bones by the application of forces and/or the stimulation and redirection of funct…
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About NPI 1386093219
Clark U. Knowlton, DDS's National Provider Identifier is 1386093219, issued on Jun 10, 2016. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Meridian, ID. The record was last updated on May 5, 2021.