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Organization
TRAVIS CLARK DDS LLC
Active
Organization
TRAVIS CLARK DDS LLC
Active
Other names
Family Dental Care Of Lebanon
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TRAVIS CLARK DDS (DENTIST)
(614) 937-0509
Entity
Organization
Contact information
Practice address
1248 COLUMBUS AVE STE 8, LEBANON, OH 45036-9005
(513) 932-0432
(513) 932-0152
Mailing address
7845 PLANTATION DR, MASON, OH 45040-5944
(614) 937-0509
(513) 932-0152
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
NULL
Other
Enumeration date
09/08/2020
Last updated
09/08/2020
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