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Individual
DR. CLINT L SERR
Active
Individual
DR. CLINT L SERR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DMD
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
12086
TN
1223G0001X
General Practice Dentistry
Primary
6606
AZ
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12086
DENTAL
TN
01
—
6606
STATE LISCENCE
AZ
01
—
D-4991
IDAHO STATE BOARD
ID
01
—
D11173
OREGON STATE DENTAL BOARD
OR
Enumeration date
12/12/2006
Last updated
08/16/2023
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