Provider Demographics
NPI:1588863203
Name:CLIFFORD, STEPHEN S (DDS)
Entity type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:S
Last Name:CLIFFORD
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:2150 3RD AVENUE
Mailing Address - Street 2:SUITE 200
Mailing Address - City:ANOKA
Mailing Address - State:MN
Mailing Address - Zip Code:55303-2200
Mailing Address - Country:US
Mailing Address - Phone:763-421-9292
Mailing Address - Fax:763-421-7559
Practice Address - Street 1:2150 3RD AVENUE
Practice Address - Street 2:SUITE 200
Practice Address - City:ANOKA
Practice Address - State:MN
Practice Address - Zip Code:55303-2200
Practice Address - Country:US
Practice Address - Phone:763-421-9292
Practice Address - Fax:763-421-7559
Is Sole Proprietor?:No
Enumeration Date:2007-07-12
Last Update Date:2011-05-27
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MND122451223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics