Provider Demographics
NPI:1407814445
Name:ZARD, CLARK D (DDS)
Entity type:Individual
Prefix:DR
First Name:CLARK
Middle Name:D
Last Name:ZARD
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 1:7814 EXCELSIOR RD
Mailing Address - Street 2:
Mailing Address - City:BAXTER
Mailing Address - State:MN
Mailing Address - Zip Code:56425-8427
Mailing Address - Country:US
Mailing Address - Phone:218-829-8863
Mailing Address - Fax:218-829-8863
Practice Address - Street 1:7814 EXCELSIOR RD
Practice Address - Street 2:
Practice Address - City:BAXTER
Practice Address - State:MN
Practice Address - Zip Code:56425-8427
Practice Address - Country:US
Practice Address - Phone:218-829-8863
Practice Address - Fax:218-829-8863
Is Sole Proprietor?:No
Enumeration Date:2006-05-01
Last Update Date:2020-08-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN9105122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist