| Jack D Clifton, Dds, Ps | |
|
52 Nw Second Street Stevenson WA 98648-0709 | |
| (509) 427-8605 | |
| (509) 427-5711 |
| Full Name | Jack D Clifton, Dds, Ps |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 52 Nw Second Street, Stevenson, Washington |
| Authorized Official Name and Position | Jack Dieterich Clifton (GENERAL DENTIST) |
| Authorized Official Contact | 5094278605 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Jack D Clifton, Dds, Ps Po Box 709 Stevenson WA 98648-0709 Ph: (509) 427-8605 | Jack D Clifton, Dds, Ps 52 Nw Second Street Stevenson WA 98648-0709 Ph: (509) 427-8605 |
| NPI Number | 1477688547 |
|---|---|
| Provider Enumeration Date | 02/22/2007 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1477688547 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | 6156 (Washington) | Primary |