Clark, Kenneth
Clark, Kenneth is an sole proprietor health care provider with primary practice located at 2524 Hillside Heights Dr , Green Bay WI 54311-6777. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Clark, Kenneth can be contacted via phone (920) 246-6118.Contact Information
Primary practice address
2524 Hillside Heights Dr
Green Bay WI 54311-6777
Phone: (920) 246-6118
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Endodontics | 1223E0200X | 3707-15 | Wisconsin |
Profile Details
| NPI number | 1619336229 |
|---|---|
| LBN Legal business name | Clark, Kenneth |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Feb 11th, 2016 |
| Last updated | Feb 11th, 2016 - about 10 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
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