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

Individual provider General Practice Dentistry · NPI 1679841811

Dr. Tanner Mark Clark, DMD is a General Practice Dentistry in Philadelphia, Pennsylvania. Practices as a sole proprietor. Licensed in Pennsylvania.

Licensed in
PA
In the registry since
2011
What do these letters mean?
DMD — Doctor of Dental Medicine
A dentist. Identical training and licensing to a DDS.

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Practice location Address checks out

2203 Fitzwater St Unit 1
Philadelphia, PA 19146-1132
Phone: (208) 317-8555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

General Practice Dentistry (primary) Taxonomy 1223G0001X · Licence DS038910 (PA)

Record details

NPI number1679841811
Entity typeIndividual (Type 1)
GenderMale
Credentials DMD
Sole proprietorYes
NPI enumeratedDecember 2, 2011
Last updated in NPPESApril 25, 2016
Mailing address2203 Fitzwater St Unit 1, Philadelphia, PA 19146-1132

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