Organization
KEITH D. CLEMENCE, DDS
Active
Other names
Clemence Dental Group
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KEITH D CLEMENCE DDS (OWNER)
(414) 425-0120
Entity
Organization
Contact information
Practice address
5751 S 108TH ST, HALES CORNERS, WI 53130-1940
(414) 425-0120
(414) 425-0978
Mailing address
5751 S 108TH ST, HALES CORNERS, WI 53130-1940
(414) 425-0120
(414) 425-0978
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
5001459
WI
1223G0001X
General Practice Dentistry
Primary
5001558
WI
Other
Enumeration date
04/23/2007
Last updated
08/22/2020
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