Bennie Clark Jr Dmd Pa is a Dental Hygienist Clinic in Jacksonville, Florida. It is located at 5475 Soutel Dr, Jacksonville, FL and its contact number is 904-764-4576. The authorized person for Bennie Clark Jr Dmd Pa is Dr. Lorraine Polite Clark
who is Vice President of the clinic and their contact number is 904-722-2200.
Bennie Clark Jr Dmd Pa Clinic An individual who has completed an accredited dental hygiene education program, and an individual who has been licensed by a state board of dental examiners to provide preventive care services under the supervision of a dentist. Functions that may be legally delegated to the dental hygienist vary based on the needs of the dentist, the educational preparation of the dental hygienist and state dental practice acts and regulations, but always include, at a minimum, scaling and polishing the teeth. To avoid misleading the public, no occupational title other than dental hygienist should be used to describe this dental auxiliary.
Complete Clinic Profile:
Bennie Clark Jr Dmd Pa Clinic speciality, address, contact phone number and fax are as below.
Patients can call on the below given phone number for appointments.
| Name: | Bennie Clark Jr Dmd Pa |
| Specialization: | Dental Hygienist |
| Clinic Address: | 5475 Soutel Dr, Jacksonville,
Florida, 32219-3464 |
| Phone: | 904-764-4576 |
| Fax: | 904-722-9900 |
Authorized/Official Person Profile:
Officially authorized person to contact for any management issues or complaints for this clinic are as below. Person's position and contact details are also mentioned below.
| Name: | Dr. Lorraine Polite Clark |
| Position: | Vice President |
| Contact Number: | 904-722-2200 |
Professional Identification Codes:
NPI number stands for National Provider Identifier which is a unique 10-digit identification number issued to health care providers in the United States by the Centers for Medicare and Medicaid Services (CMS).
NPI details for Bennie Clark Jr Dmd Pa clinic are as mentioned below.
| NPI Number: | 1295023752 |
| NPI Enumeration Date: | 19 Jul, 2011 |
| NPI Last Update On: | 01 Nov, 2019 |
Medical Licenses:
Organizations can have one or more medical licenses for different specialities in the same state or different states. Related medical licenses for Bennie Clark Jr Dmd Pa are as mentioned below.
| Specialization | License Number | State | Status | |
| Dentist | | | Primary | |
| Dental Hygienist | | | Secondary | |
Other Medical Identifiers:
Other legacy medical identifiers of the clinic such as Medicaid, Medicare PIN, NSC, UPIN etc. are mentioned as below.
| Identifier | Type | State | Issuer |
| 071395300 | Medicaid | Florida | |
Business Mailing Address:
Business mailing address can be used for mailing purpose only, for visiting purpose patients need to refer above mentioned address.
| Address: | Bennie Clark Jr Dmd Pa
5475 Soutel Dr,
Jacksonville, Florida |
| Zip: | 32219-3464 |
| Phone Number: | 904-764-4576 |
| Fax Number: | 904-722-2200 |
Patients can reach Bennie Clark Jr Dmd Pa at
5475 Soutel Dr, Jacksonville, Florida or can
call to book an appointment on 904-764-4576.
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**Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on
08 December, 2025.