Provider Demographics
NPI:1255428256
Name:MICHELS, CLAY C (DDS)
Entity type:Individual
Prefix:DR
First Name:CLAY
Middle Name:C
Last Name:MICHELS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4320 S SUNNYLANE RD
Mailing Address - Street 2:
Mailing Address - City:DEL CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73115-3742
Mailing Address - Country:US
Mailing Address - Phone:405-672-6817
Mailing Address - Fax:
Practice Address - Street 1:4320 S SUNNYLANE RD
Practice Address - Street 2:
Practice Address - City:DEL CITY
Practice Address - State:OK
Practice Address - Zip Code:73115-3742
Practice Address - Country:US
Practice Address - Phone:405-672-6817
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-10-10
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK47251223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice