Provider Demographics
NPI:1629563531
Name:COVERT, CLINTON MATTHEW (DDS)
Entity type:Individual
Prefix:
First Name:CLINTON
Middle Name:MATTHEW
Last Name:COVERT
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:656 PISA PASS
Mailing Address - Street 2:
Mailing Address - City:DAVENPORT
Mailing Address - State:FL
Mailing Address - Zip Code:33897-7452
Mailing Address - Country:US
Mailing Address - Phone:513-370-0237
Mailing Address - Fax:
Practice Address - Street 1:2612 S HWY 27
Practice Address - Street 2:
Practice Address - City:CLERMONT
Practice Address - State:FL
Practice Address - Zip Code:34711-6521
Practice Address - Country:US
Practice Address - Phone:407-965-0090
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-25
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN29848122300000X
IN12012965A122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist