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Individual

DR. MATTHEW S. CLEGG

Active
Sole proprietor

Provider details

NPI number
Gender
Man
Credential
D.D.S., M.S.

Contact information

Practice address
802 7TH ST, CLARKSTON, WA 99403-2022
(509) 758-4181
(509) 758-4756
Mailing address
802 7TH ST, CLARKSTON, WA 99403-2022
(509) 758-4181
(509) 758-4756

Taxonomy

Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
DE00010180
WA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
602 510 100
UNIFIED BUSINESS IDENT.
WA
Enumeration date
11/25/2005
Last updated
07/08/2007
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