Individual
CLAY CANNON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
202 SHELLEY DR, TYLER, TX 75701-8725
(903) 561-8600
Mailing address
202 SHELLEY DR, TYLER, TX 75701-8725
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
18036
TX
Other
Enumeration date
05/07/2007
Last updated
07/08/2007
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