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General NPI Number Information
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NPI Number | 1467701003
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Entity Type | Individual
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Provider Name | ELIZABETH LARSON CLAPHAM D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/29/2012
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Last Update Date | 02/03/2017
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Provider Practice Location Address
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Address Line | 9030 SOUTHWESTERN BLVD #3336
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City | DALLAS
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State | TX
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Zip | 75214-2236
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Country | US
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Telephone | 919-475-7242
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Fax |
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Provider Business Mailing Address
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Address Line | 9030 SOUTHWESTERN BLVD #3336
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City | DALLAS
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State | TX
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Zip | 75214-6235
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Country | US
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Telephone | 919-475-7242
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 32480
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 9392
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License Number State | NC
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