Individual
JUSTIN BICE CLEMOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D., M.D.
Contact information
Practice address
2500 W STRUB RD STE A, SANDUSKY, OH 44870-5390
(419) 627-8131
Mailing address
2500 W STRUB RD STE A, SANDUSKY, OH 44870-5390
(419) 627-8131
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
023915
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
264666
MA
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
Primary
30.023915
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
35.121660
OH
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DN18025
FL
204E00000X
Oral & Maxillofacial Surgery (D.M.D.)
DN1856941
MA
Other
Enumeration date
06/06/2007
Last updated
04/10/2024
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