Individual provider · Type 1 NPI

Michael Kenneth Clark, DDS

Oral and Maxillofacial Surgery (Dentist) · Mission Viejo, CA

NPI number 1619316403 Active

Practice location

27725 Santa Margarita Pkwy, Suite 130
Mission Viejo, CA 92691-6704

Call (949) 470-3672 Map

Fax (949) 472-2095

Specialties and licenses

TaxonomyCodeLicense
Oral and Maxillofacial Surgery (Dentist) Primary 1223S0112X41907 (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 1619316403

Michael Kenneth Clark, DDS's National Provider Identifier is 1619316403, issued on Jun 14, 2013. The primary taxonomy on file is Oral and Maxillofacial Surgery (Dentist) (1223S0112X), and the practice location is in Mission Viejo, CA. The record was last updated on Jun 14, 2013.