Organization
CLAY AND HIENER DENTISTRY PARTNERSHIP
Active
Other names
Shady Spring Dental Care
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CARL JEFFREY CLAY D.D.S. (GENERAL PARTNER)
(304) 763-4665
Entity
Organization
Contact information
Practice address
479 FLAT TOP RD, SHADY SPRING, WV 25918-8614
(304) 763-4665
(304) 763-5172
Mailing address
479 FLAT TOP RD, SHADY SPRING, WV 25918-8614
(304) 763-4665
(304) 763-5172
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2683
WV
122300000X
Dentist
3728
WV
122300000X
Dentist
3776
WV
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001875982
MT STATE BLUE CROSS
WV
01
—
1591884
UNITED CONCORDIA
WV
Enumeration date
01/23/2009
Last updated
01/26/2009
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