Provider Demographics
NPI:1710062377
Name:WILLIAMS, CLAYTON BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:BRUCE
Last Name:WILLIAMS
Suffix:
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 1:2676 S 2110 E
Mailing Address - Street 2:
Mailing Address - City:ST GEORGE
Mailing Address - State:UT
Mailing Address - Zip Code:84790-7076
Mailing Address - Country:US
Mailing Address - Phone:435-899-9886
Mailing Address - Fax:
Practice Address - Street 1:2676 S 2110 E
Practice Address - Street 2:
Practice Address - City:ST GEORGE
Practice Address - State:UT
Practice Address - Zip Code:84790-7076
Practice Address - Country:US
Practice Address - Phone:435-899-9886
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-25
Last Update Date:2009-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDD-37041223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics