Individual provider · Type 1 NPI
Carly Rene' Clark, RDH, EP
Advanced Practice Dental Therapist · Portland, OR
Practice location
3324 N Arlington Pl
Portland, OR 97217-7204
Specialties and licenses
| Taxonomy | Code | License |
|---|---|---|
| Advanced Practice Dental Therapist Primary | 125K00000X | H5380 (OR) |
Advanced Practice Dental Therapist: An Advanced Practice Dental Therapist is:<br/>(1) A dental therapist who has completed additional training beyond basic dental therapy education and provides dental services in accordance with state advanced practice dental therapist laws or statutes; or<br/>(2) A dental hygienist with a graduate degree in advanced dental therapy prepared for independent and interdependent decision making and direct accountability f…
About NPI 1760827356
Carly Rene' Clark, RDH, EP's National Provider Identifier is 1760827356, issued on May 8, 2013. The primary taxonomy on file is Advanced Practice Dental Therapist (125K00000X), and the practice location is in Portland, OR. The record was last updated on May 8, 2013.