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Contact Information

JAN D CLARK, DMD
300 NO WILLSON
602F
BOZEMAN, MT59715
 Phone: 406-586-5318
 Fax: 406-586-1635
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for JAN D CLARK · (Male)

NPI Number 1497803803
Status Active
Credentials DMD (Doctor of Medical Dentistry)
Entity Individual
Enumeration date 01/08/2007
Last updated 10/01/2024 - More than a year ago
Sole proprietor 1 No
Identifiers
  • MT License # 79
  • MT Medicaid 0390091
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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