Individual provider · Type 1 NPI

Tanner Jay Clark, DDS, M.S.

Orthodontics and Dentofacial Orthopedics Dentistry · North Liberty, IA

NPI number 1790734796 Active

Practice location

650 W. Cherry St., Suite 5
North Liberty, IA 52317

Specialties and licenses

TaxonomyCodeLicense
Orthodontics and Dentofacial Orthopedics Dentistry Primary 1223X0400X08880 (IA)

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 1790734796

Tanner Jay Clark, DDS, M.S.'s National Provider Identifier is 1790734796, issued on May 8, 2006. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in North Liberty, IA. The record was last updated on Jan 26, 2012.