| Shady Spring Dental Care | |
|
479 Flat Top Rd Shady Spring WV 25918-8614 | |
| (304) 763-4665 | |
| (304) 763-5172 |
| Full Name | Shady Spring Dental Care |
|---|---|
| Speciality | Dentist |
| Location | 479 Flat Top Rd, Shady Spring, West Virginia |
| Authorized Official Name and Position | Carl Jeffrey Clay (GENERAL PARTNER) |
| Authorized Official Contact | 3047634665 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Shady Spring Dental Care 479 Flat Top Rd Shady Spring WV 25918-8614 Ph: (304) 763-4665 | Shady Spring Dental Care 479 Flat Top Rd Shady Spring WV 25918-8614 Ph: (304) 763-4665 |
| NPI Number | 1598903973 |
|---|---|
| Provider Enumeration Date | 01/23/2009 |
| Last Update Date | 01/26/2009 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598903973 | NPI | - | NPPES |
| 1591884 | Other | WV | UNITED CONCORDIA |
| 001875982 | Other | WV | MT STATE BLUE CROSS |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 122300000X | Dentist | 2683 (West Virginia) | Primary |
| 122300000X | Dentist | 3728 (West Virginia) | Secondary |
| 122300000X | Dentist | 3776 (West Virginia) | Secondary |
C Jeff Clay, D.d.s. Inc. Dental Clinic Medicare: Not Enrolled in Medicare Practice Location: 479 Flat Top Rd, Shady Spring, WV 25918 Phone: 304-763-4665 Fax: 304-763-5172 |