Provider Demographics
NPI:1386790533
Name:LANGLOIS, CLIFFORD DEAN (DDS)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:DEAN
Last Name:LANGLOIS
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 1:233 W BADILLO ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:COVINA
Mailing Address - State:CA
Mailing Address - Zip Code:91723-1966
Mailing Address - Country:US
Mailing Address - Phone:626-332-1138
Mailing Address - Fax:626-332-1785
Practice Address - Street 1:233 W BADILLO ST
Practice Address - Street 2:SUITE B
Practice Address - City:COVINA
Practice Address - State:CA
Practice Address - Zip Code:91723-1966
Practice Address - Country:US
Practice Address - Phone:626-332-1138
Practice Address - Fax:626-332-1785
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA339491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice