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DR. MICHAEL J CLAYMORE DDS

General Practice >> Dentist >> Dental Providers

Registrant NPI Number: 1144372475

Individual Registrant:
DR. MICHAEL J CLAYMORE DDS
Gender: M
Sole Proprietor

Location and contact information for practice:
8 N DIVISION STREET  PINEHUSRT, ID 83850-0609 US
Tel: 208-682-4540  Fax: 208-682-2339

Contact information for business:
PO BOX 609  PINEHURST, ID 83850-0609 US
Tel: 208-682-4540  Fax: 208-682-2339

Registration Information:
NPI: 1144372475
Entity Type: Individual

Specialty information:

PrimaryCodeCategory/DescriptionStateLicense Number
Y1223G0001XDental Providers
Dentist
General Practice
IDD1817

Legacy codes, insurance codes and state license numbers:

IssuerNumberStateType
IDAHO DENTAL IDD1817ID01
DEA #AC1958214ID01




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