Provider Demographics
NPI:1073701892
Name:KLEIN, MICHAEL BRUCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:BRUCE
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:19 WEST 44TH STREET
Mailing Address - Street 2:SUITE 314
Mailing Address - City:NEW YORK CITY
Mailing Address - State:NY
Mailing Address - Zip Code:10036
Mailing Address - Country:US
Mailing Address - Phone:212-997-1910
Mailing Address - Fax:212-398-9128
Practice Address - Street 1:19 WEST 44TH STREET
Practice Address - Street 2:SUITE 314
Practice Address - City:NEW YORK CITY
Practice Address - State:NY
Practice Address - Zip Code:10036
Practice Address - Country:US
Practice Address - Phone:212-997-1910
Practice Address - Fax:212-398-9128
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-05
Last Update Date:2007-10-05
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NY0270041223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0700XDental ProvidersDentistProsthodontics