Individual provider · NPI-1

Nicklaus Clifford, D.D.S.

Dentist · Shawnee, OK

NPI number1013322312
StatusActive
Last updated in NPPESJun 25, 2014

Details

NPI
1013322312
Entity type
Individual (NPI-1)
Name
Nicklaus Clifford
Credential
D.D.S.
Sex
Male
Sole proprietor
No
Enumeration date
Jun 25, 2014
Last updated
Jun 25, 2014

Taxonomy and licenses

Taxonomy codeDescriptionLicenseStatePrimary
122300000X Dentist6632OKYes

Practice location

2510 E Independence St Ste 600
Shawnee, OK 74804-1839

Phone 405-273-2002 · Fax 405-273-0087

Mailing address

2510 E Independence St Ste 600
Shawnee, OK 74804-1839

Phone 405-273-2002 · Fax 405-273-0087

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