L L Clark DDS Sc

NPI #1497713176 in Boscobel, Wisconsin

Provider Information

NPI Number: 1497713176
Entity Type: Organization
Organization Name: L L Clark DDS Sc
Primary Specialty: Dentist - General Practice
Enumeration Date: May 3, 2006
Last Updated: Aug 22, 2020

Practice Location

Address: 105 EAST BLUFF STREET
City: Boscobel
State: Wisconsin
ZIP Code: 53805-9802
Phone: (608) 375-4549

Authorized Official

Name: DR. LARRY LEE CLARK, DDS
Title: DENTIST
Phone: (608) 375-4549

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Dentist - General Practice — General Practice	1223G0001X	Primary

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