Individual
DR. CLIVE B RAYNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2301 PARK AVE, SUITE 101, ORANGE PARK, FL 32073-5565
(904) 269-5195
(904) 269-7196
Mailing address
2301 PARK AVE, SUITE 101, ORANGE PARK, FL 32073-5565
(904) 269-5195
(904) 269-7196
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
DN8951
FL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
67978
BCBS
FL
Enumeration date
03/24/2006
Last updated
12/26/2012
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