Provider Demographics
NPI:1538608591
Name:CLAYTON, CHRISTOPHER ASHLEY (DMD)
Entity type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:ASHLEY
Last Name:CLAYTON
Suffix:
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 1:5 CROSSGATE CT
Mailing Address - Street 2:
Mailing Address - City:POOLER
Mailing Address - State:GA
Mailing Address - Zip Code:31322-8284
Mailing Address - Country:US
Mailing Address - Phone:912-547-0017
Mailing Address - Fax:
Practice Address - Street 1:9100 WHITE BLUFF RD STE 104
Practice Address - Street 2:
Practice Address - City:SAVANNAH
Practice Address - State:GA
Practice Address - Zip Code:31406-4673
Practice Address - Country:US
Practice Address - Phone:912-354-3474
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-02-22
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0159751223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty