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General NPI Number Information
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NPI Number | 1659526432
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Entity Type | Organization
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Legal Business Name | CLAY DENTAL, PLLC
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Dates
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Enumeration Date | 11/20/2008
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Last Update Date | 11/20/2008
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Provider Practice Location Address
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Address Line | 19214 CLAY RD STE D
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City | KATY
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State | TX
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Zip | 77449-4082
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Country | US
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Telephone | 281-463-4333
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Fax | 281-463-4908
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Provider Business Mailing Address
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Address Line | 19214 CLAY RD STE D
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City | KATY
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State | TX
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Zip | 77449-4082
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Country | US
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Telephone | 281-463-4333
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Fax | 281-463-4908
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. MARIA CALCINA
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Credential | DDS
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Telephone | 281-995-2032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 23621
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 23621
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License Number State | TX
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Taxonomy #3
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Taxonomy Code | 1223P0221X
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Taxonomy Name | Pediatric Dentistry
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License Number | 23621
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License Number State | TX
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