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NPI Profile for Dr BRENT W CLARK in WIESBADEN, NY.
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.
Specialty |
Taxonomy Code | Specialty Code | Provider Type | |
Pediatric Dentistry |
1223P0221X |
| NPI Number | 1174636419 |
|
| Status | Active | |
| Credentials | DMD (Doctor of Medical Dentistry) | |
| Entity | Individual | |
| Enumeration date | 08/17/2006 | |
| Last updated | 07/10/2025 - About 11 months ago | |
| Sole proprietor 1 | No | |
| Identifiers |
|
|
| Hospital affiliation(s) | Not Available |
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BRENT W CLARK
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