Provider Demographics
NPI:1043426182
Name:WOODS, CLIFTON J III (DDS)
Entity Type:Individual
Prefix:
First Name:CLIFTON
Middle Name:J
Last Name:WOODS
Suffix:III
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 1:9351 LAKESIDE BLVD
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-5062
Mailing Address - Country:US
Mailing Address - Phone:443-549-1300
Mailing Address - Fax:443-548-1303
Practice Address - Street 1:9351 LAKESIDE BLVD
Practice Address - Street 2:
Practice Address - City:OWINGS MILLS
Practice Address - State:MD
Practice Address - Zip Code:21117-5062
Practice Address - Country:US
Practice Address - Phone:443-549-1300
Practice Address - Fax:443-548-1303
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-15
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice