Provider Demographics
NPI:1932575586
Name:BALDWIN, CLIFTON (DDS)
Entity Type:Individual
Prefix:DR
First Name:CLIFTON
Middle Name:
Last Name:BALDWIN
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 1:5258 LOUETTA RD STE 100
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-8147
Mailing Address - Country:US
Mailing Address - Phone:281-893-4746
Mailing Address - Fax:281-376-8273
Practice Address - Street 1:5258 LOUETTA RD STE 100
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-8147
Practice Address - Country:US
Practice Address - Phone:281-893-4746
Practice Address - Fax:281-376-8273
Is Sole Proprietor?:Yes
Enumeration Date:2015-08-18
Last Update Date:2015-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX14274122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist