Provider Demographics
NPI:1972621688
Name:STOCKS, CLIFFORD L (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:L
Last Name:STOCKS
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 1:334 SHAW AVE
Mailing Address - Street 2:#125
Mailing Address - City:CLOVIS
Mailing Address - State:CA
Mailing Address - Zip Code:93612-3847
Mailing Address - Country:US
Mailing Address - Phone:559-297-8000
Mailing Address - Fax:
Practice Address - Street 1:334 SHAW AVE
Practice Address - Street 2:#125
Practice Address - City:CLOVIS
Practice Address - State:CA
Practice Address - Zip Code:93612-3847
Practice Address - Country:US
Practice Address - Phone:559-297-8000
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA284921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice