Organization
CLEARWATER DENTAL SC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. BOBBI S POTTER (OFFICE MANAGER)
(715) 514-5300
Entity
Organization
Contact information
Practice address
431 E CLAIREMONT AVE STE B, EAU CLAIRE, WI 54701-3685
(715) 514-5300
(715) 514-5302
Mailing address
431 E CLAIREMONT AVE STE B, EAU CLAIRE, WI 54701-3685
(715) 514-5300
(715) 514-5302
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
1697G
MN
Other
Enumeration date
08/10/2011
Last updated
08/10/2011
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