Provider Demographics
NPI:1851744783
Name:CLAY, ELIZABETH ALEXIS (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ALEXIS
Last Name:CLAY
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2140 KLEINERT AVE
Mailing Address - Street 2:
Mailing Address - City:BATON ROUGE
Mailing Address - State:LA
Mailing Address - Zip Code:70806-6712
Mailing Address - Country:US
Mailing Address - Phone:985-869-8602
Mailing Address - Fax:
Practice Address - Street 1:9804 BLUEBONNET BLVD STE A
Practice Address - Street 2:
Practice Address - City:BATON ROUGE
Practice Address - State:LA
Practice Address - Zip Code:70810-6479
Practice Address - Country:US
Practice Address - Phone:225-769-1969
Practice Address - Fax:225-769-1970
Is Sole Proprietor?:No
Enumeration Date:2016-07-15
Last Update Date:2018-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA6664122300000X, 1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
No122300000XDental ProvidersDentist