Clear Lake Dental LLC

NPI #1629436381 in Clear Lake, South Dakota

Provider Information

NPI Number
1629436381
Entity Type
Organization
Organization Name
Clear Lake Dental LLC
Primary Specialty
Clinic/Center - Dental
Enumeration Date
Feb 9, 2016
Last Updated
Feb 9, 2016

Practice Location

Address
210 3RD AVE SOUTH
ZIP Code
57226
Phone
(605) 874-2230

Authorized Official

Name
DR. BRIAN KELLY PROUTY, DDS
Title
OWNER
Phone
(605) 874-2230

Specialties & Taxonomy Codes

Specialty
Clinic/Center - DentalDental

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