Provider Demographics
NPI:1659526432
Name:CLAY DENTAL, PLLC
Entity Type:Organization
Organization Name:CLAY DENTAL, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARIA
Authorized Official - Middle Name:
Authorized Official - Last Name:CALCINA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:281-995-2032
Mailing Address - Street 1:19214 CLAY RD STE D
Mailing Address - Street 2:
Mailing Address - City:KATY
Mailing Address - State:TX
Mailing Address - Zip Code:77449-4082
Mailing Address - Country:US
Mailing Address - Phone:281-463-4333
Mailing Address - Fax:281-463-4908
Practice Address - Street 1:19214 CLAY RD STE D
Practice Address - Street 2:
Practice Address - City:KATY
Practice Address - State:TX
Practice Address - Zip Code:77449-4082
Practice Address - Country:US
Practice Address - Phone:281-463-4333
Practice Address - Fax:281-463-4908
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-20
Last Update Date:2008-11-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX236211223G0001X, 1223P0221X, 1223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty