| Clear Lake Dental Llc | |
|
210 3rd Ave South Clear Lake SD 57226 | |
| (605) 874-2230 | |
| (605) 874-2675 |
| Full Name | Clear Lake Dental Llc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 210 3rd Ave South, Clear Lake, South Dakota |
| Authorized Official Name and Position | Brian Kelly Prouty (OWNER) |
| Authorized Official Contact | 6058742230 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clear Lake Dental Llc 210 3rd Ave South Clear Lake SD 57226 Ph: (605) 874-2230 | Clear Lake Dental Llc 210 3rd Ave South Clear Lake SD 57226 Ph: (605) 874-2230 |
| NPI Number | 1629436381 |
|---|---|
| Provider Enumeration Date | 02/09/2016 |
| Last Update Date | 02/09/2016 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1629436381 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
Martin H Oleson Dds Pc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 South Third Ave., Clear Lake, SD 57226 Phone: 605-874-2230 Fax: 605-874-2675 | |
Embrace Clear Lake Llc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 210 3rd Ave South, Clear Lake, SD 57226 Phone: 605-874-2230 Fax: 605-657-0054 |