Provider Demographics
NPI:1528200581
Name:CLAYTON A. FINLEY DDS, LLC
Entity Type:Organization
Organization Name:CLAYTON A. FINLEY DDS, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLAYTON
Authorized Official - Middle Name:A
Authorized Official - Last Name:FINLEY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:321-254-0200
Mailing Address - Street 1:1300 W EAU GALLIE BLVD
Mailing Address - Street 2:SUITE B
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32935-5338
Mailing Address - Country:US
Mailing Address - Phone:321-956-0365
Mailing Address - Fax:321-254-2900
Practice Address - Street 1:1300 W EAU GALLIE BLVD
Practice Address - Street 2:SUITE B
Practice Address - City:MELBOURNE
Practice Address - State:FL
Practice Address - Zip Code:32935-5338
Practice Address - Country:US
Practice Address - Phone:321-956-0365
Practice Address - Fax:321-254-2900
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-04-06
Last Update Date:2015-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00142961223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty