Kemar Clarke, DMD

Individual provider Active NPI General Practice Dentistry · Lancaster, TX

NPI 1659948495 · NPPES record last updated Jul 18, 2022

Key facts

NPI
1659948495
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
38202 (TX)
Practice address
404 N Interstate 35 E Ste 118
Lancaster, TX 75146-1866
Phone
(972) 223-3500
NPI assigned
Jun 9, 2021
Sex
Male
Sole proprietor
No

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
38202TXMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 38202 TX Yes
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

404 N Interstate 35 E Ste 118
Lancaster, TX 75146-1866

Mailing address

404 N Interstate 35 E Ste 118
Lancaster, TX 75146-1866
Phone (972) 223-3500

Other practice location 1

1775 Grand Concourse Fl 6
Bronx, NY 10453-8202
Phone (718) 901-8410

Other providers in Lancaster, TX

All providers in Lancaster, TX · General Practice Dentistry in Texas

Sources for this page

Verify at the official NPI Registry.