Provider Demographics
NPI:1558406272
Name:CLIFTON, SHRENNA L (DDS)
Entity Type:Individual
Prefix:DR
First Name:SHRENNA
Middle Name:L
Last Name:CLIFTON
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:89 LOWER CREEK TRL
Mailing Address - Street 2:
Mailing Address - City:SENOIA
Mailing Address - State:GA
Mailing Address - Zip Code:30276-1958
Mailing Address - Country:US
Mailing Address - Phone:177-077-8323
Mailing Address - Fax:770-486-0656
Practice Address - Street 1:115 GENEVIEVE CT
Practice Address - Street 2:
Practice Address - City:FAYETTEVILLE
Practice Address - State:GA
Practice Address - Zip Code:30215-4857
Practice Address - Country:US
Practice Address - Phone:770-486-8229
Practice Address - Fax:770-486-0656
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-20
Last Update Date:2023-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0108051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice