Clemence, Keith Douglas

Clemence, Keith Douglas is an individual health care provider with primary practice located at 5751 S 108Th St , Hales Corners WI 53130-1940. He recently has only one registered license in Dental Providers / General Practice, which is considered as his primary health care specialty. Clemence, Keith Douglas can be contacted via phone (414) 425-0120.

Contact Information

Primary practice address
5751 S 108Th St Hales Corners WI 53130-1940
Phone: (414) 425-0120
Fax: (414) 425-0978
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / General Practice 1223G0001X 5001558 Wisconsin

Profile Details

NPI number 1811937808
LBN Legal business name Clemence, Keith Douglas
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 7th, 2006
Last updated Jul 8th, 2007 - about 18 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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