Provider Demographics
NPI:1962631036
Name:AFFORDABLE DENTURES - ST. CLAIRSVILLE, MICHAEL R. MCCLURE, D.D.S.,INC.
Entity Type:Organization
Organization Name:AFFORDABLE DENTURES - ST. CLAIRSVILLE, MICHAEL R. MCCLURE, D.D.S.,INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRACTICE OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:R
Authorized Official - Last Name:MCCLURE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:740-695-6079
Mailing Address - Street 1:68379 STEWART DR
Mailing Address - Street 2:
Mailing Address - City:SAINT CLAIRSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43950-1717
Mailing Address - Country:US
Mailing Address - Phone:740-695-6079
Mailing Address - Fax:
Practice Address - Street 1:68379 STEWART DR
Practice Address - Street 2:
Practice Address - City:SAINT CLAIRSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43950-1717
Practice Address - Country:US
Practice Address - Phone:740-695-6079
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-09
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30020265122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty