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General NPI Number Information
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NPI Number | 1518696806
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Entity Type | Individual
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Provider Name | CLAYTON PAUL BOOTH DDS
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Gender | Male
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Dates
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Enumeration Date | 06/10/2022
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Last Update Date | 07/23/2026
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Provider Practice Location Address
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Address Line | USS THEODORE ROOSEVELT CVN 71
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City | FPO
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State | AA
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Zip | 92135
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Country | US
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Telephone | 619-545-7171
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Fax |
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Provider Business Mailing Address
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Address Line | 2620 FOOTHILL DR
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City | OGDEN
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State | UT
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Zip | 84403-0528
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Country | US
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Telephone | 385-245-3071
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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 | 12879487-9922
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License Number State | UT
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Taxonomy #2
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 12879487-9922
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License Number State | UT
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