Provider Demographics
NPI:1972595650
Name:CLIFFORD, CURTIS J (DDS)
Entity Type:Individual
Prefix:DR
First Name:CURTIS
Middle Name:J
Last Name:CLIFFORD
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 1:6852 E BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MESA
Mailing Address - State:AZ
Mailing Address - Zip Code:85207-3706
Mailing Address - Country:US
Mailing Address - Phone:480-981-1755
Mailing Address - Fax:480-981-2886
Practice Address - Street 1:6852 E BROWN RD
Practice Address - Street 2:
Practice Address - City:MESA
Practice Address - State:AZ
Practice Address - Zip Code:85207-3706
Practice Address - Country:US
Practice Address - Phone:480-981-1755
Practice Address - Fax:480-981-2886
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-08-18
Last Update Date:2007-07-08
Deactivation Date:2006-03-21
Deactivation Code:
Reactivation Date:2006-04-03
Provider Licenses
StateLicense IDTaxonomies
AZAZ37581223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice