Provider Demographics
NPI:1013028075
Name:KLUFT, GERALD MCELROY (DDS, FICD, PFA)
Entity Type:Individual
Prefix:DR
First Name:GERALD
Middle Name:MCELROY
Last Name:KLUFT
Suffix:
Gender:M
Credentials:DDS, FICD, PFA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5208 E FOWLER AVE
Mailing Address - Street 2:SUITE # F
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33617-1906
Mailing Address - Country:US
Mailing Address - Phone:813-988-1103
Mailing Address - Fax:813-985-1524
Practice Address - Street 1:5208 E FOWLER AVE
Practice Address - Street 2:SUITE # F
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33617-1906
Practice Address - Country:US
Practice Address - Phone:813-988-1103
Practice Address - Fax:813-985-1524
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-31
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL65161223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics