Elizabeth J Clark, DDS
Dentist, General Practice in Old Lyme, Connecticut
1407038128- Practice location
- 19 Halls RD Ste 218, Old Lyme, CT 06371-1457
- Phone
- 860-434-7378
- Fax
- —
- Last updated
- March 9, 2010
Elizabeth Jane Clark is a Dentist, General Practice based in Old Lyme, CT. Elizabeth Jane Clark practices in Old Lyme, CT and has the professional credentials of DDS. The NPI Number for Elizabeth Jane Clark is 1407038128 and holds a License No. 009894 (CT). The current practice location address for Elizabeth Jane Clark is 19 Halls RD Ste 218, Old Lyme, CT 06371-1457 and can be reached out via phone at 860-434-7378.
Provider Profile Details
- NPI Number
- 1407038128
- Provider Name
- Elizabeth Jane Clark
- Credential
- DDS
- Provider Entity Type
- Individual
- Gender
- Female
- Address
- 19 Halls RD Ste 218, Old Lyme, CT 06371-1457
- Phone Number
- 860-434-7378
- Primary Taxonomy
- Dentist, General Practice · 1223G0001X
- Sole Proprietor
- No
- Provider Enumeration Date
- December 4, 2007
- Last Update Date
- March 9, 2010
- NPI Status
- Active
Provider Business Practice Location Address Details
- Address
- 19 Halls RD Ste 218
Old Lyme, CT 06371-1457 - City
- Old Lyme
- State
- Connecticut
- Zip
- 06371-1457
- Phone Number
- 860-434-7378
Provider Business Mailing Address Details
- Address
- 19 Halls RD Ste 218
Po Box 551
Old Lyme, CT 06371-1457 - City
- Old Lyme
- State
- CT
- Zip
- 06371-1457
- Phone Number
- 860-434-7378
License Information
- License Number
- 009894
- License State
- CT
- Taxonomy
- Dentist, General Practice · 1223G0001X · Primary
Legacy Identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| No legacy identifiers (Medicaid, Medicare or plan IDs) are on file for this provider. | |||
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Frequently Asked Questions
What is the NPI number of Elizabeth J Clark, DDS?
The NPI number of Elizabeth J Clark, DDS is 1407038128. It was assigned on December 4, 2007 and is currently active in the NPPES registry.
What is the specialty of Elizabeth J Clark, DDS?
Elizabeth J Clark, DDS is registered under the primary taxonomy Dentist, General Practice (code 1223G0001X), licensed in CT under license number 009894.
Where does Elizabeth J Clark, DDS practice?
The practice location is 19 Halls RD Ste 218, Old Lyme, CT 06371-1457. The office can be reached at 860-434-7378 (phone).
What is an NPI number?
A National Provider Identifier (NPI) is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS). It is used in HIPAA standard transactions.
How do I verify this NPI record?
This record is sourced from the public NPPES NPI Registry maintained by CMS. You can confirm it by searching NPI 1407038128 directly on the NPPES registry website.