Individual
MS. MARY H CLIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
989 W WASHINGTON ST STE 104, MARQUETTE, MI 49855-4073
(906) 226-9992
(906) 226-9982
Mailing address
989 W WASHINGTON ST STE 104, MARQUETTE, MI 49855-4073
(906) 226-9992
(906) 226-9982
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
MC016122
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
88131
DELTA DENTAL PROVIDER NUM
MI
01
—
D801057
BCBS PROVIDER NUMBER
MI
Enumeration date
10/02/2006
Last updated
07/09/2007
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