IndividualActive
Timothy Clark, DDS
NPI 1194800946 · General Practice Dentistry · Becker, MN
Provider details
- NPI number
- 1194800946
- Entity type
- Individual
- Primary specialty
- General Practice DentistryDental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- No
- License
- 10140 (MN)
Specialties & taxonomies
Dental Providers
Practice location
12392 Pleasant Ave.
Becker, MN 55308-0098
Phone: (763) 261-5350
Fax: (763) 262-5351
Approximate (ZIP-level) locationGet directions
Mailing address
Po Box 98
Becker, MN 55308-0098
Registry dates
- Enumerated
- 2006-10-26
- Last updated
- 2007-07-08
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.