Joseph R Clark, DDS

Individual provider Active NPI General Practice Dentistry · Commerce, GA

NPI 1285936005 · NPPES record last updated Aug 9, 2026

Key facts

NPI
1285936005
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN009715 (GA)
Practice address
42 Georgia Ave
Commerce, GA 30529-2320
Phone
(706) 335-4699
NPI assigned
Nov 30, 2010
Sex
Male
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN009715GAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Dentist 122300000X DN009715 GA
General Practice Dentistry 1223G0001X DN009715 GA Yes

Addresses

Primary practice location

42 Georgia Ave
Commerce, GA 30529-2320

Mailing address

42 Georgia Ave
Commerce, GA 30529-2320
Phone (706) 335-4699

Other providers in Commerce, GA

All providers in Commerce, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.