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Organization
MICHAEL J CLAYMORE DDS
Active
Organization
MICHAEL J CLAYMORE DDS
Active
Parent organization
MICHAEL J CLAYMORE DDS
Organization subpart
Yes
Provider details
NPI number
Legal business name
MICHAEL J CLAYMORE DDS
Authorized official
DR. MICHAEL J CLAYMORE DDS (DENTIST)
(208) 682-4540
Entity
Organization
Contact information
Practice address
8 N DIVISION STREET, PINEHURST, ID 83850-0609
(208) 682-4540
(208) 682-2339
Mailing address
PO BOX 609, PINEHURST, ID 83850-0609
(208) 682-4540
(208) 682-2339
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
D1817
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CS3387
CONTROLLED SUBSTANCE
ID
01
—
D1817
IDAHO DENTIST NUMBER
ID
Enumeration date
03/14/2008
Last updated
03/07/2023
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