Provider Demographics
NPI:1083757355
Name:KLENE, CARRIE A (DDS)
Entity Type:Individual
Prefix:DR
First Name:CARRIE
Middle Name:A
Last Name:KLENE
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
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Mailing Address - Street 1:715 W CARMEL DR STE 102
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-5881
Mailing Address - Country:US
Mailing Address - Phone:317-208-5525
Mailing Address - Fax:317-208-1018
Practice Address - Street 1:715 W CARMEL DR STE 102
Practice Address - Street 2:
Practice Address - City:CARMEL
Practice Address - State:IN
Practice Address - Zip Code:46032-5881
Practice Address - Country:US
Practice Address - Phone:317-208-5525
Practice Address - Fax:317-208-1018
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-15
Last Update Date:2020-04-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN12010745A204E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes204E00000XAllopathic & Osteopathic PhysiciansOral & Maxillofacial Surgery