Provider Demographics
NPI:1255668075
Name:COMPTON, CLIFFORD CLYDE III (DDSPA)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:CLYDE
Last Name:COMPTON
Suffix:III
Gender:M
Credentials:DDSPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:913 UNION ST S
Mailing Address - Street 2:
Mailing Address - City:CONCORD
Mailing Address - State:NC
Mailing Address - Zip Code:28025-5732
Mailing Address - Country:US
Mailing Address - Phone:704-786-8825
Mailing Address - Fax:704-786-8823
Practice Address - Street 1:913 UNION ST S
Practice Address - Street 2:
Practice Address - City:CONCORD
Practice Address - State:NC
Practice Address - Zip Code:28025-5732
Practice Address - Country:US
Practice Address - Phone:704-786-8825
Practice Address - Fax:704-786-8823
Is Sole Proprietor?:Yes
Enumeration Date:2009-11-16
Last Update Date:2009-11-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC37771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice