Provider Demographics
NPI:1770945453
Name:CLAROT, SAMUEL (DDS MD)
Entity type:Individual
Prefix:
First Name:SAMUEL
Middle Name:
Last Name:CLAROT
Suffix:
Gender:M
Credentials:DDS MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:10175 GATEWAY BLVD W STE 304
Mailing Address - Street 2:
Mailing Address - City:EL PASO
Mailing Address - State:TX
Mailing Address - Zip Code:79925-2203
Mailing Address - Country:US
Mailing Address - Phone:915-504-6880
Mailing Address - Fax:915-599-8579
Practice Address - Street 1:10175 GATEWAY BLVD W STE 304
Practice Address - Street 2:
Practice Address - City:EL PASO
Practice Address - State:TX
Practice Address - Zip Code:79925-2203
Practice Address - Country:US
Practice Address - Phone:915-504-6880
Practice Address - Fax:915-599-8579
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-22
Last Update Date:2024-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX37052204E00000X, 1223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
No204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial SurgeryGroup - Single Specialty