Healthcare Provider Details

I. General information

NPI: 1124956917
Provider Name (Legal Business Name): GEISE DENTAL CLIFT FARM PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/12/2026
Last Update Date: 05/14/2026
Certification Date: 05/14/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

351 JOHN HENRY WAY STE A
MADISON AL
35757-9603
US

IV. Provider business mailing address

2109 COMMERCE ST STE 200
DALLAS TX
75201-4350
US

V. Phone/Fax

Practice location:
  • Phone: 972-248-1221
  • Fax:
Mailing address:
  • Phone: 972-248-1221
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number
License Number State

VIII. Authorized Official

Name: WILLIAM ROBERT JENNINGS
Title or Position: OWNER
Credential: DDS
Phone: 940-206-8956