Provider Demographics
NPI:1659980068
Name:CLAYTON, CRAIG DOUGLASS II (DMD)
Entity Type:Individual
Prefix:DR
First Name:CRAIG
Middle Name:DOUGLASS
Last Name:CLAYTON
Suffix:II
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7166 E FAREWELL BEND CT
Mailing Address - Street 2:
Mailing Address - City:BOISE
Mailing Address - State:ID
Mailing Address - Zip Code:83716-8100
Mailing Address - Country:US
Mailing Address - Phone:949-554-3545
Mailing Address - Fax:
Practice Address - Street 1:3809 E AMITY RD STE 150
Practice Address - Street 2:
Practice Address - City:MERIDIAN
Practice Address - State:ID
Practice Address - Zip Code:83642
Practice Address - Country:US
Practice Address - Phone:208-229-1500
Practice Address - Fax:208-370-5552
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-31
Last Update Date:2022-12-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD5175122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist