Clark, Kenneth

Clark, Kenneth is an sole proprietor health care provider with primary practice located at 2524 Hillside Heights Dr , Green Bay WI 54311-6777. He recently has only one registered license in Dental Providers / Endodontics, which is considered as his primary health care specialty. Clark, Kenneth can be contacted via phone (920) 246-6118.

Contact Information

Primary practice address
2524 Hillside Heights Dr Green Bay WI 54311-6777
Phone: (920) 246-6118
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Endodontics 1223E0200X 3707-15 Wisconsin

Profile Details

NPI number 1619336229
LBN Legal business name Clark, Kenneth
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Feb 11th, 2016
Last updated Feb 11th, 2016 - about 9 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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