National Provider Identifier
Jay F. Clark, D.D.S.
Jay F. Clark, D.D.S. is listed in the NPPES registry with a primary specialty of General Practice Dentistry in Derby, NY and a listed phone number of (716) 947-4308.
Profile Overview
- NPI
- 1427241058
- Provider Type
- Individual
- Primary Specialty
- General Practice Dentistry
- Enumeration Date
- August 27, 2007
- Last Updated
- August 27, 2007
Practice Location
- 7455 Erie RD
- Lake Shore Prof Bldg
- Derby, NY 14047-9305
Phone: (716) 947-4308
Mailing Address
- 7455 Erie RD
- P.O. Box 417
- Derby, NY 14047-9305
Specialties
- General Practice Dentistry (1223G0001X)
Full Record
- NPI
- 1427241058
- Entity Type
- Individual
- Last Name
- Clark
- First Name
- Jay
- Middle Name
- F.
- Name Prefix
- Dr.
- Credential
- D.D.S.
- Mailing Street Address
- 7455 Erie RD
- Mailing Address Line 2
- P.O. Box 417
- Mailing City
- Derby
- Mailing State
- NY
- Mailing ZIP Code
- 14047-9305
- Mailing Country
- US
- Mailing Phone
- (716) 947-4308
- Practice Street Address
- 7455 Erie RD
- Practice Address Line 2
- Lake Shore Prof Bldg
- Practice City
- Derby
- Practice State
- NY
- Practice ZIP Code
- 14047-9305
- Practice Country
- US
- Practice Phone
- (716) 947-4308
- Enumeration Date
- August 27, 2007
- Last Updated
- August 27, 2007
- Sex
- Male
- Sole Proprietor
- Yes
- updated_by_file
- npidata_pfile_20050523-20260308.csv
- Taxonomies
- General Practice Dentistry (1223G0001X)