Clark, Dallas Elise

Clark, Dallas Elise is an individual health care provider with primary practice located at 2525 N Broadway Ave , Red Lodge MT 59068. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Clark, Dallas Elise can be contacted via phone (406) 446-2345.

Contact Information

Primary practice address
2525 N Broadway Ave Red Lodge MT 59068
Phone: (406) 446-2345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MED-PHYS-LIC-77353 Montana

Profile Details

NPI number 1669822664
LBN Legal business name Clark, Dallas Elise
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 21st, 2016
Last updated Sep 6th, 2019 - about 6 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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