Provider Demographics
NPI:1225712599
Name:BLUFF PARK DENTAL PLLC
Entity Type:Organization
Organization Name:BLUFF PARK DENTAL PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DOCTOR/ OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:ANDREW
Authorized Official - Last Name:CLINGAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:205-823-2577
Mailing Address - Street 1:2161 CLEARBROOK RD
Mailing Address - Street 2:
Mailing Address - City:HOOVER
Mailing Address - State:AL
Mailing Address - Zip Code:35226-1520
Mailing Address - Country:US
Mailing Address - Phone:205-823-2577
Mailing Address - Fax:
Practice Address - Street 1:2161 CLEARBROOK RD
Practice Address - Street 2:
Practice Address - City:HOOVER
Practice Address - State:AL
Practice Address - Zip Code:35226-1520
Practice Address - Country:US
Practice Address - Phone:205-823-2577
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-14
Last Update Date:2023-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental