Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bennie Clark Jr DMD PA

Organization Dentist · NPI 1295023752

Bennie Clark Jr DMD PA is a Dentist in Jacksonville, Florida. Registered with an NPI since 2011.

In the registry since
2011
Specialties on file
2
What do these letters mean?
PA — Professional association
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5475 Soutel Dr
Jacksonville, FL 32219-3464
Phone: (904) 764-4576
Fax: (904) 722-9900
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Dentist (primary) Taxonomy 122300000X
Dental Hygienist Taxonomy 124Q00000X

Record details

NPI number1295023752
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Lorraine Clark — Vice President · (904) 722-2200
Other names Soutel Dental Center Ii
NPI enumeratedJuly 19, 2011
Last updated in NPPESNovember 1, 2019
Mailing address5475 Soutel Dr, Jacksonville, FL 32219-3464

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