Provider Demographics
NPI:1598847238
Name:CLAUSS, CHARLES E JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:E
Last Name:CLAUSS
Suffix:JR
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 1:29 WASHINGTON SQ W
Mailing Address - Street 2:# 1 A
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10011-9180
Mailing Address - Country:US
Mailing Address - Phone:212-473-2343
Mailing Address - Fax:212-473-2342
Practice Address - Street 1:29 WASHINGTON SQ W
Practice Address - Street 2:# 1 A
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-9180
Practice Address - Country:US
Practice Address - Phone:212-473-2343
Practice Address - Fax:212-473-2342
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY039-4461223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice