Provider Demographics
NPI:1609942218
Name:LITVAK, CLIFFORD S (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:S
Last Name:LITVAK
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 1:695 S COLORADO BLVD
Mailing Address - Street 2:SUITE 380
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80246-8008
Mailing Address - Country:US
Mailing Address - Phone:303-777-8850
Mailing Address - Fax:303-777-8974
Practice Address - Street 1:695 S COLORADO BLVD
Practice Address - Street 2:SUITE 380
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80246-8008
Practice Address - Country:US
Practice Address - Phone:303-777-8850
Practice Address - Fax:303-777-8974
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1049271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice