Search › California › 122300000X
Glen Clark, DDS
NPI 1740339233 · on the registry since 2007
Practice
- Address
- 925 W 34th St
Room #151
Los Angeles, CA 90089 - Phone
- (213) 740-7405
- Organisation at this address
- Usc Urgent Care
Usc Redmond Imaging Center
University Of Southern California
Usc Oral And Maxillofacial Faculty PracticeInferred from a shared address, not stated in the registry. - Clinicians at this address
- 69
Registry record
- Primary taxonomy
- 122300000X
122300000X
- Also registered as
- 1223P0106X
1223S0112X - Licence states on file
- CA
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-12-05
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in California