Provider Demographics
NPI:1942432059
Name:CLAUSS, MARK RYAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:MARK
Middle Name:RYAN
Last Name:CLAUSS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 DEPOT ST STE 505
Mailing Address - Street 2:
Mailing Address - City:WATERTOWN
Mailing Address - State:CT
Mailing Address - Zip Code:06795-2685
Mailing Address - Country:US
Mailing Address - Phone:860-274-6625
Mailing Address - Fax:
Practice Address - Street 1:51 DEPOT ST STE 505
Practice Address - Street 2:
Practice Address - City:WATERTOWN
Practice Address - State:CT
Practice Address - Zip Code:06795-2685
Practice Address - Country:US
Practice Address - Phone:860-274-6625
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-08-23
Last Update Date:2023-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT0088771223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics