Individual
DR. JOHN ROBERT CLIFFORD
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS, MS
Contact information
Practice address
413 N 17TH AVE, WAUSAU, WI 54401-4226
(715) 842-4649
Mailing address
413 N 17TH AVE, WAUSAU, WI 54401-4226
(715) 842-7331
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
1002225-15
WI
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
05/21/2018
Last updated
07/01/2020
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