DR. RYAN JAMES CLARK D.D.S. NPI 1356639892

NPI Information

NPI: 1356639892
Provider Name: DR. RYAN JAMES CLARK, D.D.S.
Classification: Dentist - 1223G0001X
Entity Type: Individual

Specialization: General Practice

Address:
580 W PARKCENTER BLVD STE B
BOISE, ID
ZIP 83706
Phone: (208) 336-8478
Get Directions

DR. Ryan James Clark, D.D.S. is a general practice dentist in Boise, ID. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. DR. Ryan James Clark, D.D.S. NPI is 1356639892. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a male.

The provider's business location address is:

580 W PARKCENTER BLVD STE B
BOISE, ID
ZIP 83706
Phone: (208) 336-8478
Fax: (208) 342-2703

The enumeration date for this NPI number is 7/19/2011 and was last updated on 7/19/2011.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	1223G0001X	Dentist	General Practice	4375	IDAHO	Yes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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