Provider Demographics
NPI:1144485210
Name:MCCLUNG, RALPH CLAY JR (DMD)
Entity type:Individual
Prefix:DR
First Name:RALPH
Middle Name:CLAY
Last Name:MCCLUNG
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:300 MONTGOMERY HWY
Mailing Address - Street 2:
Mailing Address - City:VESTAVIA HILLS
Mailing Address - State:AL
Mailing Address - Zip Code:35216-1804
Mailing Address - Country:US
Mailing Address - Phone:205-979-1800
Mailing Address - Fax:205-979-1830
Practice Address - Street 1:300 MONTGOMERY HWY
Practice Address - Street 2:
Practice Address - City:VESTAVIA HILLS
Practice Address - State:AL
Practice Address - Zip Code:35216-1804
Practice Address - Country:US
Practice Address - Phone:205-979-1800
Practice Address - Fax:205-979-1830
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-28
Last Update Date:2008-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL34401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice