Provider Demographics
NPI:1073793303
Name:KLEIN CROSSING DENTAL, P.A.
Entity Type:Organization
Organization Name:KLEIN CROSSING DENTAL, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MELISSA
Authorized Official - Middle Name:L
Authorized Official - Last Name:WELTY
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:832-717-0595
Mailing Address - Street 1:6531 FM 2920 RD
Mailing Address - Street 2:
Mailing Address - City:SPRING
Mailing Address - State:TX
Mailing Address - Zip Code:77379-2613
Mailing Address - Country:US
Mailing Address - Phone:832-717-0595
Mailing Address - Fax:
Practice Address - Street 1:6531 FM 2920 RD
Practice Address - Street 2:
Practice Address - City:SPRING
Practice Address - State:TX
Practice Address - Zip Code:77379-2613
Practice Address - Country:US
Practice Address - Phone:832-717-0595
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-11-03
Last Update Date:2016-04-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX19455122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty