Provider Demographics
NPI:1093870891
Name:SENSENIG, CLIFFORD DEAN (DMD)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:DEAN
Last Name:SENSENIG
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 1:1418 BRUNNERVILLE ROAD
Mailing Address - Street 2:
Mailing Address - City:LITITZ
Mailing Address - State:PA
Mailing Address - Zip Code:17543-9726
Mailing Address - Country:US
Mailing Address - Phone:717-626-7101
Mailing Address - Fax:
Practice Address - Street 1:1829 MARKET STREET
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17103-2524
Practice Address - Country:US
Practice Address - Phone:717-236-0300
Practice Address - Fax:717-236-4611
Is Sole Proprietor?:No
Enumeration Date:2006-12-22
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS027088L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
111101OtherUNISON
PA0012259630001Medicaid
275291OtherGATEWAY HEALTH PLUS