Bennie Clark Jr Dmd Pa is a Dental 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 have dental surgeons who are specialized in dentistry, diagnosis, prevention, and treatment of diseases and conditions of the oral cavity. The dentist's supporting team aids in providing oral health services. The dental team includes dental assistants, dental hygienists, dental technicians, and sometimes dental therapists.
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:
Dentistry
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. Data of this site is collected from Medicare & Medicaid Services (CMS) and NPPES. Last updated on 10 March, 2025.