Provider Demographics
NPI:1548523665
Name:HAMRICK, CLAYTON MACK (DMD, MD)
Entity type:Individual
Prefix:DR
First Name:CLAYTON
Middle Name:MACK
Last Name:HAMRICK
Suffix:
Gender:M
Credentials:DMD, MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11517 PERFECT PL
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33626-3364
Mailing Address - Country:US
Mailing Address - Phone:919-622-0899
Mailing Address - Fax:
Practice Address - Street 1:410 N PLANT AVE
Practice Address - Street 2:
Practice Address - City:PLANT CITY
Practice Address - State:FL
Practice Address - Zip Code:33563-7248
Practice Address - Country:US
Practice Address - Phone:813-755-9102
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-06-22
Last Update Date:2025-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN197861223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial Surgery