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General NPI Number Information
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NPI Number | 1639716475
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Entity Type | Organization
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Legal Business Name | CHAD E. CLEMENT, DDS, PC
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Dates
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Enumeration Date | 11/27/2019
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Last Update Date | 12/31/2019
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Provider Practice Location Address
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Address Line | 1256 BAY ST
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City | FLORENCE
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State | OR
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Zip | 97439-9648
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Country | US
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Telephone | 541-997-3423
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Fax | 541-997-8749
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Provider Business Mailing Address
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Address Line | PO BOX 1487
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City | FLORENCE
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State | OR
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Zip | 97439-0075
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Country | US
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Telephone | 541-997-3423
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Fax | 541-997-8749
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Authorized Official
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Title or Position | DR.
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Name | DR. CHAD E CLEMENT
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Credential | DDS
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Telephone | 541-997-3423
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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