| Clayton Dental Offices, Pllc | |
|
775 Graves St Clayton NY 13624-1503 | |
| (315) 686-5142 | |
| (315) 686-2310 |
| Full Name | Clayton Dental Offices, Pllc |
|---|---|
| Speciality | Dentist |
| Location | 775 Graves St, Clayton, New York |
| Authorized Official Name and Position | Della Hattie Ramsdell (PRACTICE MANAGER) |
| Authorized Official Contact | 3156865142 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Clayton Dental Offices, Pllc 775 Graves St Po Box 405 Clayton NY 13624-1503 Ph: (315) 686-5142 | Clayton Dental Offices, Pllc 775 Graves St Clayton NY 13624-1503 Ph: (315) 686-5142 |
| NPI Number | 1649332180 |
|---|---|
| Provider Enumeration Date | 12/14/2006 |
| Last Update Date | 03/06/2019 |
| Medicare PECOS PAC ID | 7810288842 |
|---|---|
| Medicare Enrollment ID | O20190904001000 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1649332180 | NPI | - | NPPES |
| 02145935 | Medicaid | NY | |
| 1952355208 | Other | NY | INDIVIDUAL NPI # |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 046003 (New York) | Primary |
| 332B00000X | Durable Medical Equipment & Medical Supplies | 046003 (New York) | Secondary |
| Provider Name | Scott Allen Laclair |
|---|---|
| Provider Type | Practitioner - Dentist |
| Provider Identifiers | NPI Number: 1952355208 PECOS PAC ID: 3173820107 Enrollment ID: I20190906000134 |