Provider Demographics
NPI:1578685483
Name:MENTON, CLAUDIA LOUISE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAUDIA
Middle Name:LOUISE
Last Name:MENTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4431 RAVINEWOOD DRIVE
Mailing Address - Street 2:
Mailing Address - City:COMMERCE TOWNSHIP
Mailing Address - State:MI
Mailing Address - Zip Code:48382
Mailing Address - Country:US
Mailing Address - Phone:248-684-9750
Mailing Address - Fax:734-422-1800
Practice Address - Street 1:14700 FARMINGTON ROAD
Practice Address - Street 2:SUITE #105
Practice Address - City:LIVONIA
Practice Address - State:MI
Practice Address - Zip Code:48154
Practice Address - Country:US
Practice Address - Phone:734-422-3666
Practice Address - Fax:734-422-1800
Is Sole Proprietor?:No
Enumeration Date:2007-04-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI13487122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist