Provider Demographics
NPI:1346364650
Name:CLAEYS, MICHELE L (DMD)
Entity Type:Individual
Prefix:DR
First Name:MICHELE
Middle Name:L
Last Name:CLAEYS
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 PROFESSIONAL PKWY
Mailing Address - Street 2:
Mailing Address - City:MARTINEZ
Mailing Address - State:GA
Mailing Address - Zip Code:30907-6527
Mailing Address - Country:US
Mailing Address - Phone:706-868-8155
Mailing Address - Fax:706-868-5703
Practice Address - Street 1:2920 PROFESSIONAL PKWY
Practice Address - Street 2:
Practice Address - City:MARTINEZ
Practice Address - State:GA
Practice Address - Zip Code:30907-6527
Practice Address - Country:US
Practice Address - Phone:706-868-8155
Practice Address - Fax:706-868-5703
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA102091223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice