Provider Demographics
NPI:1679793236
Name:STEED, CLYDE G JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLYDE
Middle Name:G
Last Name:STEED
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 1:2350 ATLANTA HWY
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CUMMING
Mailing Address - State:GA
Mailing Address - Zip Code:30040-8026
Mailing Address - Country:US
Mailing Address - Phone:770-781-9201
Mailing Address - Fax:678-513-6373
Practice Address - Street 1:2350 ATLANTA HWY
Practice Address - Street 2:SUITE 100
Practice Address - City:CUMMING
Practice Address - State:GA
Practice Address - Zip Code:30040-8026
Practice Address - Country:US
Practice Address - Phone:770-781-9201
Practice Address - Fax:678-513-6373
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA85501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice