Provider Demographics
NPI:1972947356
Name:CLAIR FAMILY DENTAL CORPORATION
Entity Type:Organization
Organization Name:CLAIR FAMILY DENTAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:MR
Authorized Official - First Name:ISAAC
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLAIR
Authorized Official - Suffix:
Authorized Official - Credentials:DDSA
Authorized Official - Phone:515-279-0856
Mailing Address - Street 1:1145 66TH ST
Mailing Address - Street 2:
Mailing Address - City:WINDSOR HEIGHTS
Mailing Address - State:IA
Mailing Address - Zip Code:50324-1705
Mailing Address - Country:US
Mailing Address - Phone:515-279-0856
Mailing Address - Fax:515-255-6907
Practice Address - Street 1:1145 66TH ST
Practice Address - Street 2:
Practice Address - City:WINDSOR HEIGHTS
Practice Address - State:IA
Practice Address - Zip Code:50324-1705
Practice Address - Country:US
Practice Address - Phone:515-279-0856
Practice Address - Fax:515-255-6907
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-04-29
Last Update Date:2013-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty