Provider Demographics
NPI:1275540940
Name:CLEMENTS, STUART MCPHERSON (DDS)
Entity Type:Individual
Prefix:DR
First Name:STUART
Middle Name:MCPHERSON
Last Name:CLEMENTS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:13203 HADLEY ST
Mailing Address - Street 2:SUITE #206
Mailing Address - City:WHITTIER
Mailing Address - State:CA
Mailing Address - Zip Code:90601-4519
Mailing Address - Country:US
Mailing Address - Phone:562-698-0291
Mailing Address - Fax:562-698-0294
Practice Address - Street 1:13203 HADLEY ST
Practice Address - Street 2:SUITE #206
Practice Address - City:WHITTIER
Practice Address - State:CA
Practice Address - Zip Code:90601-4519
Practice Address - Country:US
Practice Address - Phone:562-698-0291
Practice Address - Fax:562-698-0294
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA422891223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice