Individual
DR. PATRICK T CLANCY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11904 W NORTH AVE STE 105, WAUWATOSA, WI 53226-2062
(414) 454-0700
Mailing address
11904 W NORTH AVE STE 105, WAUWATOSA, WI 53226-2062
(608) 225-4856
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1001596-15
WI
Other
Enumeration date
06/15/2017
Last updated
05/21/2020
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