Provider Demographics
NPI:1497972475
Name:CLAGETT, JAMES L (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMES
Middle Name:L
Last Name:CLAGETT
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 1:1608 W FURNACE BRANCH RD
Mailing Address - Street 2:SUITE 100
Mailing Address - City:GLEN BURNIE
Mailing Address - State:MD
Mailing Address - Zip Code:21061-1432
Mailing Address - Country:US
Mailing Address - Phone:410-859-1038
Mailing Address - Fax:
Practice Address - Street 1:1608 W FURNACE BRANCH RD
Practice Address - Street 2:SUITE 100
Practice Address - City:GLEN BURNIE
Practice Address - State:MD
Practice Address - Zip Code:21061-1432
Practice Address - Country:US
Practice Address - Phone:410-859-1038
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-04-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD6392122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist