Provider Demographics
NPI:1598897811
Name:MACAULAY, CLARE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLARE
Middle Name:
Last Name:MACAULAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:CLARE
Other - Middle Name:MACAULAY
Other - Last Name:LINTEREUR
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:28212 KELLY JOHNSON PKWY.
Mailing Address - Street 2:SUITE 205
Mailing Address - City:VALENCIA
Mailing Address - State:CA
Mailing Address - Zip Code:91355
Mailing Address - Country:US
Mailing Address - Phone:661-259-7272
Mailing Address - Fax:661-259-7995
Practice Address - Street 1:28212 KELLY JOHNSON PKWY.
Practice Address - Street 2:SUITE 205
Practice Address - City:VALENCIA
Practice Address - State:CA
Practice Address - Zip Code:91355
Practice Address - Country:US
Practice Address - Phone:661-259-7272
Practice Address - Fax:661-259-7995
Is Sole Proprietor?:No
Enumeration Date:2007-03-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA41851122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA41851OtherSTATE LICENSE NUMBER