Provider Demographics
NPI:1245291533
Name:PLISKY, CLARENCE J III (DDS)
Entity type:Individual
Prefix:MR
First Name:CLARENCE
Middle Name:J
Last Name:PLISKY
Suffix:III
Gender:M
Credentials:DDS
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Mailing Address - Street 1:3200 E CAMELBACK RD STE 182
Mailing Address - Street 2:
Mailing Address - City:PHOENIX
Mailing Address - State:AZ
Mailing Address - Zip Code:85018-2326
Mailing Address - Country:US
Mailing Address - Phone:602-952-9521
Mailing Address - Fax:602-952-0073
Practice Address - Street 1:3200 E CAMELBACK RD STE 182
Practice Address - Street 2:
Practice Address - City:PHOENIX
Practice Address - State:AZ
Practice Address - Zip Code:85018-2326
Practice Address - Country:US
Practice Address - Phone:602-952-9521
Practice Address - Fax:602-952-0073
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2012-06-11
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
AZD52141223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice