Provider Demographics
NPI:1790777068
Name:LAYTON, CECIL CRAIG (DDS)
Entity Type:Individual
Prefix:
First Name:CECIL
Middle Name:CRAIG
Last Name:LAYTON
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:CRAIG
Other - Middle Name:
Other - Last Name:LAYTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:DDS
Mailing Address - Street 1:227 S HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:CORTEZ
Mailing Address - State:CO
Mailing Address - Zip Code:81321-3763
Mailing Address - Country:US
Mailing Address - Phone:970-739-8133
Mailing Address - Fax:505-368-5612
Practice Address - Street 1:US HIGHWAY 491 NORTH
Practice Address - Street 2:
Practice Address - City:SHIPROCK
Practice Address - State:NM
Practice Address - Zip Code:87420
Practice Address - Country:US
Practice Address - Phone:505-368-5626
Practice Address - Fax:505-368-5612
Is Sole Proprietor?:No
Enumeration Date:2005-08-22
Last Update Date:2010-03-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD25101223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice