Provider Demographics
NPI:1518036292
Name:SPRINGER, CLIFFORD WILLIAM (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:WILLIAM
Last Name:SPRINGER
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 1:160 S 1000 E
Mailing Address - Street 2:SUITE 310
Mailing Address - City:SALT LAKE CITY
Mailing Address - State:UT
Mailing Address - Zip Code:84102-1428
Mailing Address - Country:US
Mailing Address - Phone:801-355-4582
Mailing Address - Fax:801-534-0247
Practice Address - Street 1:160 S 1000 E
Practice Address - Street 2:SUITE 310
Practice Address - City:SALT LAKE CITY
Practice Address - State:UT
Practice Address - Zip Code:84102-1428
Practice Address - Country:US
Practice Address - Phone:801-355-4582
Practice Address - Fax:801-534-0247
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-07
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
UT130943-99221223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice