Randolph Lynn Clark, DDS Valid NPI
Individual provider · General Practice Dentistry · Edmond, OK
- NPI
- 1649347097
- Type
- Individual (Type 1)
- Primary specialty
- General Practice Dentistry (Dentist)
- Specialty group
- Dental Providers
- Taxonomy code
- 1223G0001X
- License number
- OK4992 (OK)
- Sex
- Male
- Sole proprietor
- Yes
- Enumerated
- 2006-11-29
- Last updated
- 2008-12-26
Practice location
301 S Boulevard St, Suite 118
Edmond, OK 73034-3878
(405) 348-9182