Provider Demographics
NPI:1003153560
Name:CLAEYS, AMY LACY (DDS)
Entity Type:Individual
Prefix:DR
First Name:AMY
Middle Name:LACY
Last Name:CLAEYS
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:LACY
Other - Middle Name:
Other - Last Name:CLAEYS
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:1050 ROAD RUNNER ST
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59602-0543
Mailing Address - Country:US
Mailing Address - Phone:406-442-1377
Mailing Address - Fax:406-442-1377
Practice Address - Street 1:1050 ROAD RUNNER ST
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59602-0543
Practice Address - Country:US
Practice Address - Phone:406-442-1377
Practice Address - Fax:406-442-1377
Is Sole Proprietor?:No
Enumeration Date:2013-01-03
Last Update Date:2013-01-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2054122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist