Provider Demographics
NPI:1467402511
Name:MCCLAY, LAURIE SUE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAURIE
Middle Name:SUE
Last Name:MCCLAY
Suffix:
Gender:F
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:PO BOX 12558
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67277
Mailing Address - Country:US
Mailing Address - Phone:316-722-7331
Mailing Address - Fax:316-722-7586
Practice Address - Street 1:8833 WEST MAPLE
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67209
Practice Address - Country:US
Practice Address - Phone:316-722-7331
Practice Address - Fax:316-722-7586
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS66621223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice