Individual
DR. MARK C CLAYTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
4540 E OGLETHORPE HWY, SUITE A, HINESVILLE, GA 31313-1431
(912) 369-3692
(912) 369-3938
Mailing address
4540 E OGLETHORPE HWY, SUITE A, HINESVILLE, GA 31313-1431
(912) 369-3692
(912) 369-3938
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
011978
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00933567A
—
GA
01
—
1352952
UNITED CONCORDIA
GA
Enumeration date
03/15/2006
Last updated
02/24/2011
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