Healthcare Provider Details

I. General information

NPI: 1710708698
Provider Name (Legal Business Name): CLIFF DENTAL CORPORATIOIN
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 10/23/2024
Last Update Date: 10/23/2024
Certification Date: 10/22/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4128 STANLEY BLVD
PLEASANTON CA
94566-6246
US

IV. Provider business mailing address

4128 STANLEY BLVD
PLEASANTON CA
94566-6246
US

V. Phone/Fax

Practice location:
  • Phone: 510-410-7419
  • Fax:
Mailing address:
  • Phone: 510-410-7419
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: DR. WILLIAM C CLIFF
Title or Position: CEO
Credential: DDS
Phone: 510-410-7419