Healthcare Provider Details

I. General information

NPI: 1346455474
Provider Name (Legal Business Name): CLIFFORD N. AUTEN, D.D.S,
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/11/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

305 S BOSQUE ST SUITE A
WHITNEY TX
76692-2736
US

IV. Provider business mailing address

PO BOX 1576
WHITNEY TX
76692-1576
US

V. Phone/Fax

Practice location:
  • Phone: 254-694-3114
  • Fax: 254-694-7084
Mailing address:
  • Phone: 254-694-3114
  • 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: DR. CLIFFORD N. AUTEN
Title or Position: OWNER
Credential: D.D.S.
Phone: 254-694-3114