Provider Demographics
NPI:1144330960
Name:RATCLIFF, ROBERT CLIFFORD (DDS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:CLIFFORD
Last Name:RATCLIFF
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2441 HIGHWAY 98 W
Mailing Address - Street 2:SUITE 107
Mailing Address - City:SANTA ROSA BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32459
Mailing Address - Country:US
Mailing Address - Phone:250-622-2226
Mailing Address - Fax:850-622-2246
Practice Address - Street 1:2441 HIGHWAY 98 W
Practice Address - Street 2:SUITE 107
Practice Address - City:SANTA ROSA BEACH
Practice Address - State:FL
Practice Address - Zip Code:32459
Practice Address - Country:US
Practice Address - Phone:250-622-2226
Practice Address - Fax:850-622-2246
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN69661223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice