Individual
DR. JACK DIETERICH CLIFTON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
52 NW SECOND STREET, STEVENSON, WA 98648
(509) 427-8605
(509) 427-5711
Mailing address
PO BOX 709, STEVENSON, WA 98648-0709
(509) 427-8605
(509) 427-5711
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
6156
WA
Other
Enumeration date
02/22/2007
Last updated
07/08/2007
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