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KENNETH C. CLARK DDS,MS
NPI 1639568603
Clinic/Center - Dental in Green Bay, WI

Active since January 14, 2015
2524 HILLSIDE HEIGHTS DR, GREEN BAY, WI 54311(920) 246-6118 Get Directions Write a Review

NPPES record last updated: January 14, 2015. Verified against the NPPES registry weekly; last sync: August 16, 2026.

About Kenneth C. Clark Dds,ms NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KENNETH C. CLARK DDS,MS (NPI 1639568603) is a healthcare organization registered as a dental in Green Bay, Wisconsin and active in the NPI registry since January 2015. The organization lists Kenneth Charles Clark, Endodontist, as its authorized official.

NPPES Registry Identity

NPI1639568603
Entity TypeOrganization
Primary Taxonomy261QD0000X
Legal Business NameKENNETH C. CLARK DDS,MS
Location Address2524 HILLSIDE HEIGHTS DRGreen Bay, WI 54311-6777
Mailing Address2524 Hillside Heights DrGreen Bay, WI 54311-6777 · (920) 246-6118
Phone(920) 246-6118
Organization SubpartNo
Authorized OfficialKenneth Charles ClarkEndodontist · (920) 246-6118
Enumeration DateJanuary 14, 2015
✔ NPI 1639568603 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyClinic/Center · DentalAmbulatory Health Care Facilities
Taxonomy Code261QD0000X
License✔ Licensed in WI · 3707-15
2524 HILLSIDE HEIGHTS DR, Green Bay, WI 54311
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Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kenneth C. Clark Dds,ms's NPI number?

The NPI number for Kenneth C. Clark Dds,ms is 1639568603. It was assigned to this organization in the NPPES registry on January 14, 2015.

Where is Kenneth C. Clark Dds,ms located?

Kenneth C. Clark Dds,ms is located at 2524 Hillside Heights Dr, Green Bay, WI 54311. The listed phone number is (920) 246-6118.

What is Kenneth C. Clark Dds,ms's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Dental, with taxonomy code 261QD0000X.

When was this NPI record last updated?

The NPPES record for Kenneth C. Clark Dds,ms was last updated on January 14, 2015. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.