Timothy Paul Clark, DDS

General Practice Dentistry · Becker, MN

Individual Active NPI

NPI number 1194800946

Practice location

12392 Pleasant Ave.
Becker, MN 55308-0098
Phone
(763) 261-5350
Fax
(763) 262-5351

Open in Google Maps

NPI record

NPI
1194800946
Entity type
Individual (Type 1)
Enumeration date
October 26, 2006
Last updated
July 8, 2007
Sole proprietor
No

Specialties & taxonomy codes

TaxonomyCodeLicenseState
General Practice Dentistry Primary 1223G0001X 10140 MN

Mailing address

PO Box 98
12392 Pleasant Ave.
Becker, MN 55308-0098
Phone
(763) 261-5350
Fax
(763) 262-5351

About Dr. Clark

Timothy Paul Clark, DDS is a healthcare provider registered in the NPI registry with the primary taxonomy General Practice Dentistry (code 1223G0001X). The practice location is 12392 Pleasant Ave., Becker, MN 55308-0098. The NPI number 1194800946 was assigned on October 26, 2006 and the record was last updated on July 8, 2007.

Dr. Clark lists a license in the registry: #10140 (MN) for General Practice Dentistry. License numbers are self-reported to NPPES; verify them with the state licensing board.

Frequently asked questions

What is the NPI number of Timothy Paul Clark, DDS?

The NPI number is 1194800946.

What is the phone number of Dr. Clark?

The phone number listed for the practice location is (763) 261-5350.

Where is Dr. Clark located?

12392 Pleasant Ave., Becker, MN 55308-0098.

What is the taxonomy code for Dr. Clark?

The primary taxonomy code is 1223G0001X – General Practice Dentistry.

Is this information correct?

All details come from the public NPPES registry. Providers can update their record at nppes.cms.hhs.gov; changes appear here after the next weekly update.