Provider Demographics
NPI:1306828884
Name:MCCARTHY-CLIFFORD, LETITIA (DDS)
Entity Type:Individual
Prefix:
First Name:LETITIA
Middle Name:
Last Name:MCCARTHY-CLIFFORD
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2001 EL CENTRO FAMILIAR BLVD SW
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87105-4592
Mailing Address - Country:US
Mailing Address - Phone:505-873-7400
Mailing Address - Fax:505-224-8767
Practice Address - Street 1:2001 EL CENTRO FAMILIAR BLVD SW
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87105-4592
Practice Address - Country:US
Practice Address - Phone:505-873-7400
Practice Address - Fax:505-224-8767
Is Sole Proprietor?:No
Enumeration Date:2005-11-18
Last Update Date:2011-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMDD1531122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist