Provider Demographics
NPI:1346455474
Name:CLIFFORD N. AUTEN, D.D.S,
Entity Type:Organization
Organization Name:CLIFFORD N. AUTEN, D.D.S,
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CLIFFORD
Authorized Official - Middle Name:N
Authorized Official - Last Name:AUTEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:254-694-3114
Mailing Address - Street 1:PO BOX 1576
Mailing Address - Street 2:
Mailing Address - City:WHITNEY
Mailing Address - State:TX
Mailing Address - Zip Code:76692-1576
Mailing Address - Country:US
Mailing Address - Phone:254-694-3114
Mailing Address - Fax:
Practice Address - Street 1:305 S BOSQUE ST
Practice Address - Street 2:SUITE A
Practice Address - City:WHITNEY
Practice Address - State:TX
Practice Address - Zip Code:76692-2736
Practice Address - Country:US
Practice Address - Phone:254-694-3114
Practice Address - Fax:254-694-7084
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-11
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TXG60413OtherTEXAS CHIP