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Contact Information

KATHERINE E CLARK, DMD
130 BEN CASEY DR
SUITE 105
FORT MILL, SC29708-6567
 Phone: 803-547-8200
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Dentist

122300000X
 

Pediatric Dentistry

1223P0221X
Indicates primary specialty

NPI Profile & details for KATHERINE E CLARK · (Female)

NPI # 1194749978
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 07/26/2006
Last updated 07/10/2012 - About 14 years ago
Sole proprietor 1 No
Identifiers
  • NC License # 9012
  • SC License # 4123
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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