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Individual
DR. CLAYTON ROLAND SHEPARD
Active
Individual
DR. CLAYTON ROLAND SHEPARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
DEN-DEN-LIC-24480
MT
1223G0001X
General Practice Dentistry
10035MN
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
10035MN
DENTAL LICENSE NUMBER
MN
01
—
DEN-DEN-LIC-24480
DENTAL LICENSE NUMBER
MT
Enumeration date
10/19/2005
Last updated
10/01/2025
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