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DR. EUGENE S CLARKE DDS

>> Dentist >> Dental Providers

Registrant NPI Number: 1659591790

Individual Registrant:
DR. EUGENE S CLARKE DDS
Gender: M
Not Sole Proprietor

Location and contact information for practice:
516 SOUTH LOCUST  CENTRALIA, IL 62801 US
Tel: 618-532-2500  Fax: 618-532-1477

Contact information for business:
516 SOUTH LOCUST  CENTRALIA, IL 62801 US
Tel: 618-532-2500  Fax: 618-532-1477

Registration Information:
NPI: 1659591790
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y122300000XDental Providers
Dentist
IL19012840

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType




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