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Contact Information

DRS PETER AND LISA CLARK FAMILY AND COSMETIC DENTISTRY
101 E 9TH STREET
BONHAM, TX75418
 Phone: 903-583-8023
 Fax: 903-583-1291
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

General Practice

1223G0001X
Indicates primary specialty

NPI Profile & details for DRS PETER AND LISA CLARK FAMILY AND COSMETIC DENTISTRY

NPI Number 1376655357
LBN Legal business name DRS PETER AND LISA CLARK FAMILY AND COSMETIC DENTISTRY
Authorized official LISA CLARK - (CORP SECRETARY)
Entity Organization
Organization subpart 1 No
Enumeration date 08/31/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
TX License # 20340
TX License # 20341
Other 1318239 UNITED CONCORDIA
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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