Provider Demographics
NPI:1780799346
Name:CLARKE, GEORGE B JR (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:B
Last Name:CLARKE
Suffix:JR
Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:7429 N 1ST ST
Mailing Address - Street 2:SUITE 101
Mailing Address - City:FRESNO
Mailing Address - State:CA
Mailing Address - Zip Code:93720-2852
Mailing Address - Country:US
Mailing Address - Phone:559-448-9870
Mailing Address - Fax:559-490-4510
Practice Address - Street 1:7429 N 1ST ST
Practice Address - Street 2:SUITE 101
Practice Address - City:FRESNO
Practice Address - State:CA
Practice Address - Zip Code:93720-2852
Practice Address - Country:US
Practice Address - Phone:559-448-9870
Practice Address - Fax:559-490-4510
Is Sole Proprietor?:No
Enumeration Date:2006-08-21
Last Update Date:2008-06-03
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CA234321223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics