IndividualActive
John Clark, D.D.S.
NPI 1699864520 · Orthodontics and Dentofacial Orthopedics Dentistry · Gulfport, MS
Provider details
- NPI number
- 1699864520
- Entity type
- Individual
- Primary specialty
- Orthodontics and Dentofacial Orthopedics DentistryDental Providers
- Credential
- D.D.S.
- Sex
- Male
- Sole proprietor
- No
- License
- OR-050-82 (MS)
Mailing address
411 Security Sq
Gulfport, MS 39507-1922
Registry dates
- Enumerated
- 2006-10-11
- Last updated
- 2010-09-28
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.