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Dr. Brent Wayne Clark, DMD
Pediatric Dentist in Fort Irwin, California
NPI 1174636419

Brent Wayne Clark is a Pediatric Dentist based in Fort Irwin, CA and is specialized in Pediatric Dentistry. Brent Wayne Clark practices in Fort Irwin, CA and has the professional credentials of DMD. The NPI Number for Brent Wayne Clark is 1174636419 and holds a License No. 7735 (California).

The current practice location address for Brent Wayne Clark is 390 North Loop Rd., Fort Irwin, CA and can be reached out via phone at 760-383-5289.

Location: 390 North Loop Rd., Fort Irwin, CA, 92310-1598
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
person
Provider Profile Details
NPI Number
1174636419
Provider Name
Brent Wayne Clark
Credential
DMD
Provider Entity Type
Individual
Gender
Male
Address
390 North Loop Rd., Fort Irwin, CA, 92310-1598
Phone Number
760-383-5289
Fax Number
Provider Enumeration Date
08/17/2006
Last Update Date
03/08/2024
institution
Provider Business Practice Location Address Details
Address
390 North Loop Rd.
City
Fort Irwin
State
California
Zip
92310
Phone Number
760-383-5289
Fax Number
person
Provider Business Mailing Address Details
Address
390 North Loop Rd.
City
Fort Irwin
State
California
Zip
92310
Phone Number
760-383-5289
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
Pediatric Dentistry
Taxonomy
1223P0221X
License No.
7735 (Kentucky)
Definition
An age-defined specialty that provides both primary and comprehensive preventive and therapeutic oral health care for infants and children through adolescence, including those with special health care needs.
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