Provider Demographics
NPI:1972985166
Name:LEVERTON, CLAIRE DESHAZER (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLAIRE
Middle Name:DESHAZER
Last Name:LEVERTON
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:ELIZABETH
Other - Middle Name:CLAIRE
Other - Last Name:DESHAZER
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:2501 STEMLEY BRIDGE RD.
Mailing Address - Street 2:
Mailing Address - City:PELL CITY
Mailing Address - State:AL
Mailing Address - Zip Code:35128
Mailing Address - Country:US
Mailing Address - Phone:205-884-1691
Mailing Address - Fax:205-338-6921
Practice Address - Street 1:2501 STEMLEY BRIDGE RD.
Practice Address - Street 2:
Practice Address - City:PELL CITY
Practice Address - State:AL
Practice Address - Zip Code:35128
Practice Address - Country:US
Practice Address - Phone:205-884-1691
Practice Address - Fax:205-338-6921
Is Sole Proprietor?:No
Enumeration Date:2015-06-24
Last Update Date:2016-12-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL61911223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice