# C JEFF CLAY, D.D.S. INC.

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1982765517
- **Authorized official:** DR. CARL JEFFREY CLAY D. D.S. (PRESIDENT)
- **Authorized official phone:** (304) 763-4665

## Contact information

- **Practice address:** 479 FLAT TOP RD, SHADY SPRING, WV 25918
- **Practice address phone:** (304) 763-4665
- **Practice address fax:** (304) 763-5172
- **Mailing address:** 479 FLAT TOP RD, SHADY SPRING, WV 25918-8614
- **Mailing address phone:** (304) 763-4665
- **Mailing address fax:** (304) 763-5172

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | 2683 | WV | Yes |

## Other

- **Enumeration date:** 12/13/2006
- **Last updated:** 01/26/2009

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 01 | — | 001875982 | MOUNTAIN STATE BLUE CROSS | WV |
| 01 | — | 1591884 | UNITRED CONCORDIA | WV |