Healthcare Provider Details

I. General information

NPI: 1144209412
Provider Name (Legal Business Name): DANIEL P. CLIFFORD DMD MD
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 01/13/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

NAVAL HOSPITAL OKINAWA PSC 482 BOX 1600
FPO AP
96362
JP

IV. Provider business mailing address

PSC 482 BOX 2758
FPO AP
96362
JP

V. Phone/Fax

Practice location:
  • Phone: 0116117437585
  • Fax:
Mailing address:
  • Phone: 011816117437585
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223S0112X
TaxonomyOral and Maxillofacial Surgery (Dentist)
License NumberDN 11429
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: