| NPI | 1710105630 |
|---|---|
| Other Name | CLEMENCE DENTAL GROUP |
| Entity Type | Organization |
| Authorized Contact | KEITH D CLEMENCE Owner 414-425-0120 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: WI 5001558) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: WI 5001459) |
| Enumeration Date | 2007-04-23 |
| Last Update Date | 2020-08-22 |