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
- City
- Clear Lake
- State
- South Dakota
- 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 - Dental — Dental |
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