MEDICARE: CLAYTON SCHOMMER 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	9438	IA

General Provider Information

NPI Number	:	1679039002
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	CLAYTON SCHOMMER DMD

Provider Business Mailing Address
First Line	:	5014 LEPRECHAUN DR
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52807-7613
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	2010 E 38TH ST STE 105
Second Line	:
City	:	DAVENPORT
State	:	IA
Zip	:	52807-1179
Country	:	US
Telephone Number	:	563-355-5177
Fax Number	:

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

Provider Enumeration Date	:	02/11/2019
Last Update Date	:	02/11/2019

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Directions to “ CLAYTON SCHOMMER DMD” Practice Location

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