Provider Demographics
NPI:1851439111
Name:ROSEMARY K AND TIMOTHY J CLAY DMD
Entity Type:Organization
Organization Name:ROSEMARY K AND TIMOTHY J CLAY DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL DENTISTRY
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLAY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD,FAGD
Authorized Official - Phone:302-998-0500
Mailing Address - Street 1:533 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WILMINGTON
Mailing Address - State:DE
Mailing Address - Zip Code:19804-3910
Mailing Address - Country:US
Mailing Address - Phone:302-998-0500
Mailing Address - Fax:302-993-0784
Practice Address - Street 1:533 MAIN ST
Practice Address - Street 2:
Practice Address - City:WILMINGTON
Practice Address - State:DE
Practice Address - Zip Code:19804-3910
Practice Address - Country:US
Practice Address - Phone:302-998-0500
Practice Address - Fax:302-993-0784
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DEDE9341223G0001X
DEDE9421223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
Not Answered1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty