IndividualActive
Jeffrey Clark, DDS
NPI 1649261850 · Oral and Maxillofacial Surgery (Dentist) · Bowling Green, KY
Provider details
- NPI number
- 1649261850
- Entity type
- Individual
- Primary specialty
- Oral and Maxillofacial Surgery (Dentist)Dental Providers
- Credential
- DDS
- Sex
- Male
- Sole proprietor
- Yes
- License
- 8960 (KY)
Specialties & taxonomies
Dental Providers
Dental Providers
Practice location
1802 Rockingham Ave
Bowling Green, KY 42104-3348
Phone: (270) 783-0064
Fax: (270) 901-1997
Approximate (ZIP-level) locationGet directions
Mailing address
1802 Rockingham Ave
Bowling Green, KY 42104-3348
Registry dates
- Enumerated
- 2005-11-04
- Last updated
- 2021-09-21
- Certified
- 2021-09-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.