Provider Demographics
NPI:1346734605
Name:CELANDER, CLAYTON CHRISTOPHER (DMD)
Entity Type:Individual
Prefix:
First Name:CLAYTON
Middle Name:CHRISTOPHER
Last Name:CELANDER
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:615 A1A N STE 103
Mailing Address - Street 2:
Mailing Address - City:PONTE VEDRA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32082-2748
Mailing Address - Country:US
Mailing Address - Phone:904-273-9353
Mailing Address - Fax:
Practice Address - Street 1:615 A1A N STE 103
Practice Address - Street 2:
Practice Address - City:PONTE VEDRA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32082-2748
Practice Address - Country:US
Practice Address - Phone:904-273-9353
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-20
Last Update Date:2022-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN23548122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist