MEDICARE: DR. CHRISTOPHER KEITH CLAUS D.D.S., M.S.D.

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	1223P0221X	Pediatric Dentistry	24732	TX
2	1223P0221X	Pediatric Dentistry	61096	CA

General Provider Information

NPI Number	:	1245461920
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. CHRISTOPHER KEITH CLAUS D.D.S., M.S.D.

Provider Business Mailing Address
First Line	:	24 DEL PRADO CIR
Second Line	:
City	:	FAIRFIELD
State	:	CA
Zip	:	94533-1864
Country	:	US
Telephone Number	:	713-435-9250
Fax Number	:

Provider Business Practice Location Address
First Line	:	2041 BRONZE STAR DR
Second Line	:
City	:	WOODLAND
State	:	CA
Zip	:	95776-5427
Country	:	US
Telephone Number	:	530-668-9187
Fax Number	:

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

Provider Enumeration Date	:	07/29/2009
Last Update Date	:	06/07/2012

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