Provider Demographics
NPI:1477676781
Name:CLAEYS, CHRISTIAN LEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHRISTIAN
Middle Name:LEE
Last Name:CLAEYS
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 1:2600 WINNE AVE STE C
Mailing Address - Street 2:
Mailing Address - City:HELENA
Mailing Address - State:MT
Mailing Address - Zip Code:59601-4900
Mailing Address - Country:US
Mailing Address - Phone:406-443-8000
Mailing Address - Fax:406-443-8345
Practice Address - Street 1:2600 WINNE AVE STE C
Practice Address - Street 2:
Practice Address - City:HELENA
Practice Address - State:MT
Practice Address - Zip Code:59601-4900
Practice Address - Country:US
Practice Address - Phone:406-443-8000
Practice Address - Fax:406-443-8345
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MT2042122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MT0111554Medicaid
MT5511400OtherCHIP