Dr Jack Dieterich Clifton, DDS is a
Dentist - General Practice based in Stevenson, Washington. Dr Jack Dieterich Clifton is licensed to practice in Washington (license number 6156) and his current practice location is
52 Nw Second Street, Stevenson, Washington. He can be reached at his office (for appointments etc.) via phone at
(509) 427-8605.
NPI number for Dr Jack Dieterich Clifton is 1568597631 and his current mailing address is Po Box 709, Stevenson, Washington. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1568597631.
Healthcare Provider's Profile
| Full Name | Dr Jack Dieterich Clifton |
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| Gender | Male |
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| Speciality | Dentist - General Practice |
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| Location | 52 Nw Second Street, Stevenson, Washington |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1568597631
- Provider Enumeration Date: 02/22/2007
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Jack Dieterich Clifton such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1568597631 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 1223G0001X | Dentist - General Practice | 6156 (Washington) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Jack Dieterich Clifton is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Jack Dieterich Clifton, DDS
Po Box 709,
Stevenson, WA 98648-0709
Ph: (509) 427-8605 | Dr Jack Dieterich Clifton, DDS
52 Nw Second Street,
Stevenson, WA 98648
Ph: (509) 427-8605 |
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