Provider Demographics
NPI:1215666706
Name:OAKEY, CLARK KEVIN (DDS)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:KEVIN
Last Name:OAKEY
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1502 N BRAZOS ST
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-2017
Mailing Address - Country:US
Mailing Address - Phone:254-694-3111
Mailing Address - Fax:
Practice Address - Street 1:1502 N BRAZOS ST
Practice Address - Street 2:
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2017
Practice Address - Country:US
Practice Address - Phone:254-694-3111
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-09
Last Update Date:2022-06-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX384881223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice