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

Clark Oral & Facial Surgery - Burley

Organization Oral and Maxillofacial Surgery Clinic/Center · NPI 1356133870

Clark Oral & Facial Surgery - Burley is an Oral and Maxillofacial Surgery Clinic/Center in Burley, Idaho. Registered with an NPI since 2025.

In the registry since
2025

Practice location Address checks out

1404 Pomerelle Ave Ste A2
Burley, ID 83318-2013
Phone: (208) 831-2901
Fax: (208) 736-6249
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Oral and Maxillofacial Surgery Clinic/Center (primary) Taxonomy 261QS0112X

Record details

NPI number1356133870
Entity typeOrganization (Type 2)
Organization subpartYes
Parent organizationClark Oral & Facial Surgery - Burley
Authorized official Durella Holmes — Practice Manager · (208) 831-2900
Other names Clark Oral & Facial Surgery, Pc
NPI enumeratedMay 20, 2025
Last updated in NPPESMay 20, 2025
Certification dateMay 20, 2025
Mailing address1404 Pomerelle Ave Ste A2, Burley, ID 83318-2013