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General NPI Number Information
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NPI Number | 1972947356
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Entity Type | Organization
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Legal Business Name | CLAIR FAMILY DENTAL CORPORATION
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Dates
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Enumeration Date | 04/29/2013
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Last Update Date | 04/29/2013
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Provider Practice Location Address
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Address Line | 1145 66TH ST
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50324-1705
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Country | US
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Telephone | 515-279-0856
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Fax | 515-255-6907
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Provider Business Mailing Address
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Address Line | 1145 66TH ST
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City | WINDSOR HEIGHTS
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State | IA
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Zip | 50324-1705
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Country | US
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Telephone | 515-279-0856
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Fax | 515-255-6907
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Authorized Official
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Title or Position | DENTIST
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Name | MR. ISAAC J CLAIR
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Credential | DDSA
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Telephone | 515-279-0856
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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 |
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License Number State |
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