| Clay D Cannon, Dds, Pllc | |
|
202 Shelley Dr Tyler TX 75701-8725 | |
| (903) 561-8600 | |
| Not Available |
| Full Name | Clay D Cannon, Dds, Pllc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 202 Shelley Dr, Tyler, Texas |
| Authorized Official Name and Position | Clay Cannon (OWNER) |
| Authorized Official Contact | 9035618600 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Clay D Cannon, Dds, Pllc 202 Shelley Dr Tyler TX 75701-8725 Ph: (903) 561-8600 | Clay D Cannon, Dds, Pllc 202 Shelley Dr Tyler TX 75701-8725 Ph: (903) 561-8600 |
| NPI Number | 1245436187 |
|---|---|
| Provider Enumeration Date | 06/26/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1245436187 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 18036 (Texas) | Primary |
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