Clark, Travis
Clark, Travis is an individual health care provider with primary practice located at 1248 Columbus Ave Ste 8, Lebanon OH 45036. He recently has only one registered license in Dental Providers / Dentist, which is considered as his primary health care specialty. Clark, Travis can be contacted via phone (513) 932-0432.Contact Information
Primary practice address
1248 Columbus Ave Ste 8
Lebanon OH 45036
Phone: (513) 932-0432
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Dentist | 122300000X | 30022366 | Ohio |
Profile Details
| NPI number | 1548344203 |
|---|---|
| LBN Legal business name | Clark, Travis |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 25th, 2006 |
| Last updated | Jul 8th, 2007 - about 19 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1548344203 | NPPES |
| Ohio | MEDICAID | 2668466 |
Popular Providers
-
Young, Jerry A
14 E Silver St , Lebanon OH 45036-1804 -
Peters, Michael Craig
600 Mound Ct , Lebanon OH 45036 -
Boscarillo, Frank
3791 S.R. 63 , Lebanon OH 45036 -
Moeller, Tera M
736 Columbus Ave , Lebanon OH 45036-1765 -
Sanai, Nima
1514 W Devon Ave , Chicago IL 60660-1314 -
Haas, Sarah E
600 Mound Ct , Lebanon OH 45036-1994 -
Haas, David Robert
600 Mound Ct , Lebanon OH 45036 -
Arbona, Emily Grace
736 Columbus Ave , Lebanon OH 45036-1765