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CLARK ORAL SURGERY AND IMPLANT CENTER NPI 1598285777


NPI Information

NPI: 1598285777
Provider Name: CLARK ORAL SURGERY AND IMPLANT CENTER

Doing Business As: DR. TYLER L. CLARK

Classification: Clinic/Center - 261QD0000X
Entity Type: Organization

Specialization: Dental

Address:
9430 SW CORAL ST STE 200
TIGARD, OR
ZIP 97223
Phone: (503) 245-1100
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CLARK ORAL SURGERY AND IMPLANT CENTER is a dental clinic center in Tigard, OR. CLARK ORAL SURGERY AND IMPLANT CENTER NPI is 1598285777. The provider is registered as an organization entity type.
The provider Is Doing Business As Dr. Tyler L. Clark.

The provider's business location address is:

9430 SW CORAL ST STE 200
TIGARD, OR
ZIP 97223-692
Phone: (503) 245-1100
Fax: (503) 473-8300

The provider's authorized official is Esther Mastrandrea .
The authorized official title is Office Manager and has the following contact phone number (503) 245-1100.

The enumeration date for this NPI number is 6/20/2017 and was last updated on 7/21/2022.


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
1261QD0000XClinic/CenterDentalD10177OREGONYes

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: 5/5/2024

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