Individual
DR. CLAYTON EDWARD DAVIS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
613 WATAUGA ST, SUITE E, KINGSPORT, TN 37660-4429
(423) 247-7741
(423) 247-7441
Mailing address
613 WATAUGA ST, SUITE E, KINGSPORT, TN 37660-4429
(423) 247-7741
(423) 247-7441
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DS-8381
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4123697
BLUE CROSS BLUE SHIELD
TN
05
—
9178841
—
TN
Enumeration date
01/18/2007
Last updated
07/08/2007
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