Clark Elon Smith D.M.D.

NPI 1891007902 - Dentist - 1223X0400X

NPI Details
NPI 1891007902
Gender Male
Enumeration Date 07/06/2010
Last Updated 07/06/2010
Entity Type Individual
Active Over 6 years ago
Practice Location
7117 GREEN BAY RD
KENOSHA WI, 53142-1450, US
Phone (262) 942-7000
Fax
Business Location
7117 GREEN BAY RD
KENOSHA WI, 53142-1450, US
Phone (262) 942-7000
Fax
Toxanomy
Taxonomy Code 1223X0400X
License State Wisconsin
License Number 6556-15
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According to our database, Dr. Clark Elon Smith D.M.D. NPI is 1891007902, taxonomy code is 1223X0400X and license number is 6556-15, license state is located at Wisconsin. Clark Elon Smith D.M.D. physically located at 7117 Green Bay Rd, Kenosha WI, 53142-1450. NPI Number Clark Elon Smith D.M.D. has the Individual type.

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1891007902 NPI number is provided on an as is basis without warranty of any kind. 1891007902 is maintained by the National Plan & Provider Enumeration System. The contents of Clark Elon Smith D.M.D. are for informational purposes only.