| NPI | 1578346748 |
|---|---|
| Doing Business As | DUSTIN S CLEVIDENCE DMD LLC |
| Entity Type | Organization |
| Authorized Contact | AMANDA MCGILL Office Manager 812-477-3393 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Enumeration Date | 2023-08-14 |
| Last Update Date | 2023-11-29 |