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Organization

EMBRACE CLEAR LAKE LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
BRIAN PROUTY DDS (OWNER)
(605) 874-2230
Entity
Organization

Contact information

Practice address
210 3RD AVE SOUTH, CLEAR LAKE, SD 57226
(605) 874-2230
(605) 657-0054
Mailing address
210 3RD AVE SOUTH, CLEAR LAKE, SD 57226
(605) 874-2230
(605) 657-0054

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary

Other

Enumeration date
12/21/2023
Last updated
12/21/2023
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