Provider Demographics
NPI:1609389493
Name:WILLS, CLAYTON RAY (DDS)
Entity type:Individual
Prefix:
First Name:CLAYTON
Middle Name:RAY
Last Name:WILLS
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:DR
Other - First Name:CLAYTON
Other - Middle Name:RAY
Other - Last Name:WILLS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:CLAY
Mailing Address - Street 1:8406 DUDLEY DR
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78230-4521
Mailing Address - Country:US
Mailing Address - Phone:210-920-4533
Mailing Address - Fax:
Practice Address - Street 1:20821 US HIGHWAY 281 N STE 310
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78258-7597
Practice Address - Country:US
Practice Address - Phone:210-494-4488
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-11-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX33067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX33067OtherDENTAL LICENSE
TXFW6969173OtherDEA