IndividualActive
Clark Knowlton, D.D.S.
NPI 1386093219 · Orthodontics and Dentofacial Orthopedics Dentistry · Meridian, ID
Provider details
- NPI number
- 1386093219
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- Yes
- License
- DD5108 (NM)
Specialties & taxonomies
Dental Providers
Dental Providers
Student, Health Care
Practice location
543 W Gable St
Meridian, ID 83646-6355
Phone: (310) 562-8760
Approximate (ZIP-level) locationGet directions
Mailing address
111 E 210th St
Bronx, NY 10467-2401
Registry dates
- Enumerated
- 2016-06-10
- Last updated
- 2021-05-05
- Certified
- 2021-05-05
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.