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General NPI Number Information
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NPI Number | 1609049683
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Entity Type | Organization
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Legal Business Name | STEPHEN L. CLAYBON DDS, INC.
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Dates
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Enumeration Date | 04/10/2008
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Last Update Date | 04/10/2008
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Provider Practice Location Address
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Address Line | 285 E MAIN ST
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City | BATAVIA
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State | OH
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Zip | 45103-3072
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Country | US
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Telephone | 513-732-0541
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Fax | 513-732-0552
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Provider Business Mailing Address
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Address Line | 285 E MAIN ST
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City | BATAVIA
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State | OH
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Zip | 45103-3072
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Country | US
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Telephone | 513-732-0541
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Fax | 513-732-0552
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. STEPHEN L CLAYBON
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Credential | DDS
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Telephone | 513-732-0541
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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 | 30-014390
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License Number State | OH
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