Provider Demographics
NPI:1437720661
Name:CLINGER, CHANCE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CHANCE
Middle Name:A
Last Name:CLINGER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1321 W CANARY WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4335
Mailing Address - Country:US
Mailing Address - Phone:385-375-9544
Mailing Address - Fax:
Practice Address - Street 1:808 N MISSION PKWY
Practice Address - Street 2:
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85194-8412
Practice Address - Country:US
Practice Address - Phone:520-426-3639
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-07-08
Last Update Date:2021-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZNONE122300000X
AZD011085122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist