Individual provider · Type 1 NPI

Kelly Clark, DDS

General Practice Dentistry · Decatur, IL

NPI number 1942379458 Active

Practice location

3737 E Rte 36
Decatur, IL 62521-5028

Call (217) 423-2400 Map

Fax (217) 423-2460

Mailing address

3737 E Route 36
Decatur, IL 62521

Specialties and licenses

TaxonomyCodeLicense
General Practice Dentistry Primary 1223G0001X019026315 (IL)

General Practice Dentistry: A general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs.

Other general practice dentistry providers in Decatur

See all in Decatur →

About NPI 1942379458

Kelly Clark, DDS's National Provider Identifier is 1942379458, issued on Nov 7, 2006. The primary taxonomy on file is General Practice Dentistry (1223G0001X), and the practice location is in Decatur, IL. The record was last updated on Jun 15, 2026.