Individual
ROGER E CLARK
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
736 COLUMBUS AVE, LEBANON, OH 45036-1608
(513) 932-1370
(513) 932-0814
Mailing address
736 COLUMBUS AVE, LEBANON, OH 45036-1608
(513) 932-1370
(513) 932-0814
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
13795
OH
Other
Enumeration date
05/10/2007
Last updated
07/08/2007
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