Individual
DR. CLYDE DANFORTH MARLOW
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
740 1ST ST, MACON, GA 31201-6840
(478) 745-0200
Mailing address
740 1ST ST, MACON, GA 31201-6840
(478) 745-0200
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
6880
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
6880
LICENSE
GA
Enumeration date
04/18/2007
Last updated
07/08/2007
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