Organization Name: | JEFFREY C KLEIMAN DMD PC |
NPI Number: | 1003090200 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | JEFFREY C KLEIMAN (PRESIDENT) |
Mailing Address: | 13660 N 94th Dr E-3 Peoria |
State: | AZ US |
Postal Code: | 853814209 |
Phone Number: | 6239744799 |
Fax Number: | |
NPI Enumeration Date: | 12/24/2007 |
NPI Last Update Date: | 12/24/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 261QD0000X |
License Number: | 2450 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | AZ |
Taxonomy Type: | Ambulatory Health Care Facilities |
Taxonomy Classification: | Clinic/Center |
Taxonomy Specialization: | Dental |
Taxonomy Definition: |