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Individual

DR. CLIFTON THEODORE FORSBERG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4626 PEACH ST, ERIE, PA 16509-2007
(814) 864-0684
(814) 864-0685
Mailing address
4626 PEACH ST, ERIE, PA 16509-2007
(814) 864-0684
(814) 864-0685

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
30-017451
OH
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
DS022897L
PA

Other

Enumeration date
12/09/2006
Last updated
07/08/2007
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