| Allison Clark Dmd Llc | |
|
540 W Main St New Lebanon OH 45345-9172 | |
| (937) 687-0700 | |
| (937) 687-6099 |
| Full Name | Allison Clark Dmd Llc |
|---|---|
| Speciality | Dentist |
| Location | 540 W Main St, New Lebanon, Ohio |
| Authorized Official Name and Position | Allison B Clark (OWNER) |
| Authorized Official Contact | 9376870700 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Allison Clark Dmd Llc 540 W Main St New Lebanon OH 45345-9172 Ph: (937) 687-0700 | Allison Clark Dmd Llc 540 W Main St New Lebanon OH 45345-9172 Ph: (937) 687-0700 |
| NPI Number | 1427897388 |
|---|---|
| Provider Enumeration Date | 05/21/2024 |
| Last Update Date | 05/21/2024 |
| Medicare PECOS PAC ID | 5395275648 |
|---|---|
| Medicare Enrollment ID | O20250217000133 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1427897388 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | (* (Not Available)) | Primary |
| 332BC3200X | Durable Medical Equipment & Medical Supplies - Customized Equipment | (* (Not Available)) | Secondary |
Karen Goulden Dds Inc Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 540 W Main St, New Lebanon, OH 45342 Phone: 937-687-0700 Fax: 937-687-0700 |