MEDICARE: LINDALEE CLAYTON DMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	DN16952	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1013911767
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	LINDALEE CLAYTON DMD

Provider Business Mailing Address
First Line	:	1392 JORDAN ROAD STE A
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811
Country	:	US
Telephone Number	:	256-852-9110
Fax Number	:	256-852-3443

Provider Business Practice Location Address
First Line	:	1392 JORDAN ROAD STE A
Second Line	:
City	:	HUNTSVILLE
State	:	AL
Zip	:	35811
Country	:	US
Telephone Number	:	256-852-9110
Fax Number	:	256-852-3443

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/10/2005
Last Update Date	:	03/13/2019

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