Individual provider · Type 1 NPI

Jerry R. Clark, DDS, MS

Orthodontics and Dentofacial Orthopedics Dentistry · Greensboro, NC

NPI number 1619203551 Active

Practice location

1115 W Friendly Ave
Greensboro, NC 27401-1844

Fax (336) 273-8038

Specialties and licenses

Taxonomy	Code	License
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	3338 (PA)

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 1619203551

Jerry R. Clark, DDS, MS's National Provider Identifier is 1619203551, issued on Oct 28, 2009. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Greensboro, NC. The record was last updated on Oct 28, 2009.