Individual provider · Type 1 NPI

Andrew Edward Clark, DMD

Orthodontics and Dentofacial Orthopedics Dentistry · Tallahassee, FL

NPI number 1992017164 Active

Practice location

5555 Roanoke Trail
Tallahassee, FL 32312

Fax (850) 385-9476

Specialties and licenses

Taxonomy	Code	License
Student in an Organized Health Care Education/Training Program	390200000X	DN 19032 (FL)
Orthodontics and Dentofacial Orthopedics Dentistry Primary	1223X0400X	DN 19032 (FL)

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 1992017164

Andrew Edward Clark, DMD's National Provider Identifier is 1992017164, issued on Jul 5, 2010. The primary taxonomy on file is Orthodontics and Dentofacial Orthopedics Dentistry (1223X0400X), and the practice location is in Tallahassee, FL. The record was last updated on Apr 24, 2025.