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Travis Clark Dds Llc
Dental Clinic/Center in Lebanon, Ohio
NPI 1093329914

Travis Clark Dds Llc is a Dental Clinic/Center based in Mason, OH and is specialized in Dental. Travis Clark Dds Llc practices in Lebanon, OH. The NPI Number for Travis Clark Dds Llc is 1093329914 and holds a License No. (Ohio).

The current practice location address for Travis Clark Dds Llc is 1248 Columbus Ave Ste 8, Lebanon, OH and can be reached out via phone at 513-932-0432 and via fax at 513-932-0152.

Location: 1248 Columbus Ave Ste 8, Lebanon, OH, 45040-5944
Profile Details Legacy Identifiers Practice Address Mailing Address Primary Taxonomy
institution
Provider Profile Details
NPI Number
1093329914
Provider Name
Travis Clark Dds Llc
Credential
Provider Entity Type
Organization
Address
1248 Columbus Ave Ste 8, Lebanon, OH, 45040-5944
Phone Number
513-932-0432
Fax Number
513-932-0152
Provider Enumeration Date
09/08/2020
Last Update Date
03/10/2024
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Provider's Legacy Identifiers
Identifier Type State Issuer
2668466 05 OH
institution
Provider Business Practice Location Address Details
Address
1248 Columbus Ave Ste 8
City
Lebanon
State
Ohio
Zip
45036-9005
Phone Number
513-932-0432
Fax Number
513-932-0152
person
Provider Business Mailing Address Details
Address
1248 Columbus Ave Ste 8
City
Lebanon
State
Ohio
Zip
45036-9005
Phone Number
513-932-0432
Fax Number
513-932-0152
person
Provider's Taxonomy Details 1
Type
Ambulatory Health Care Facilities
Classification
Clinic/Center
Speciality
Dental
Taxonomy
261QD0000X
License No.
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Definition
Definition to come...
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