Provider Demographics
NPI:1992287155
Name:TEEMS, CLIFFORD RHODES (DMD)
Entity type:Individual
Prefix:DR
First Name:CLIFFORD
Middle Name:RHODES
Last Name:TEEMS
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:660 WESLEY DR
Mailing Address - Street 2:
Mailing Address - City:JACKSON
Mailing Address - State:GA
Mailing Address - Zip Code:30233-1845
Mailing Address - Country:US
Mailing Address - Phone:770-362-7293
Mailing Address - Fax:
Practice Address - Street 1:183 KEYS FERRY ST
Practice Address - Street 2:
Practice Address - City:MCDONOUGH
Practice Address - State:GA
Practice Address - Zip Code:30253-3232
Practice Address - Country:US
Practice Address - Phone:770-957-7445
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-04
Last Update Date:2018-09-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0157361223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice