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Kelly Clark Dds Pc
General Practice Dentistry in Decatur, Illinois
NPI 1982839056

Kelly Clark Dds Pc is a General Practice Dentistry based in Decatur, IL and is specialized in General Practice. Kelly Clark Dds Pc practices in Decatur, IL. The NPI Number for Kelly Clark Dds Pc is 1982839056 and holds a License No. 060009717 (Illinois).

The current practice location address for Kelly Clark Dds Pc is 3737 Us Rt 36 E, Decatur, IL and can be reached out via phone at 217-423-2400.

Location: 3737 Us Rt 36 E, Decatur, IL, 62521
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1982839056
Provider Name
Kelly Clark Dds Pc
Credential
Provider Entity Type
Organization
Address
3737 Us Rt 36 E, Decatur, IL, 62521
Phone Number
217-423-2400
Fax Number
Provider Enumeration Date
05/19/2009
Last Update Date
03/09/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
1073693883 01 IL BLUE CROSS
1700959020 01 IL BLUE CROSS
1801059100 01 IL BLUE CROSS
1942379458 01 IL BLUE CROSS
institution
Provider Business Practice Location Address Details
Address
3737 Us Rt 36 E
City
Decatur
State
Illinois
Zip
62521
Phone Number
217-423-2400
Fax Number
person
Provider Business Mailing Address Details
Address
3737 Us Rt 36 E
City
Decatur
State
Illinois
Zip
62521
Phone Number
217-423-2400
Fax Number
person
Provider's Taxonomy Details 1
Type
Dental Providers
Classification
Dentist
Speciality
General Practice
Taxonomy
1223G0001X
License No.
060009717 (Illinois)
Definition
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.
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