Provider Demographics
NPI:1942377973
Name:CULLINGS, CLIFFORD REED (DDS)
Entity Type:Individual
Prefix:
First Name:CLIFFORD
Middle Name:REED
Last Name:CULLINGS
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 1:2310 N MOLTER RD
Mailing Address - Street 2:SUITE 202
Mailing Address - City:LIBERTY LAKE
Mailing Address - State:WA
Mailing Address - Zip Code:99019-8621
Mailing Address - Country:US
Mailing Address - Phone:509-926-0066
Mailing Address - Fax:509-926-7085
Practice Address - Street 1:2310 N MOLTER RD
Practice Address - Street 2:SUITE 202
Practice Address - City:LIBERTY LAKE
Practice Address - State:WA
Practice Address - Zip Code:99019-8621
Practice Address - Country:US
Practice Address - Phone:509-926-0066
Practice Address - Fax:509-926-7085
Is Sole Proprietor?:No
Enumeration Date:2006-11-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA9129122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WA5037510Medicaid