Provider Demographics
NPI:1922106368
Name:MISSION HILLS ENDODONTICS, A DENTAL PRACTICE
Entity Type:Organization
Organization Name:MISSION HILLS ENDODONTICS, A DENTAL PRACTICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:C
Authorized Official - Last Name:CLIFF
Authorized Official - Suffix:
Authorized Official - Credentials:DDS, MSD
Authorized Official - Phone:510-794-6600
Mailing Address - Street 1:39572 STEVENSON PL
Mailing Address - Street 2:SUITE 121
Mailing Address - City:FREMONT
Mailing Address - State:CA
Mailing Address - Zip Code:94539-3075
Mailing Address - Country:US
Mailing Address - Phone:510-794-6600
Mailing Address - Fax:510-794-1525
Practice Address - Street 1:39572 STEVENSON PL
Practice Address - Street 2:SUITE 121
Practice Address - City:FREMONT
Practice Address - State:CA
Practice Address - Zip Code:94539-3075
Practice Address - Country:US
Practice Address - Phone:510-794-6600
Practice Address - Fax:510-794-1525
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA396191223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty