Provider Demographics
NPI:1083917231
Name:KLEIN, ELIZABETH ANN (DDS)
Entity Type:Individual
Prefix:DR
First Name:ELIZABETH
Middle Name:ANN
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:3565 LEE HWY
Mailing Address - Street 2:S3/B
Mailing Address - City:ARLINGTON
Mailing Address - State:VA
Mailing Address - Zip Code:22207-3716
Mailing Address - Country:US
Mailing Address - Phone:571-447-5577
Mailing Address - Fax:571-482-6982
Practice Address - Street 1:3565 LEE HWY
Practice Address - Street 2:S3/B
Practice Address - City:ARLINGTON
Practice Address - State:VA
Practice Address - Zip Code:22207-3716
Practice Address - Country:US
Practice Address - Phone:571-447-5577
Practice Address - Fax:571-482-6982
Is Sole Proprietor?:No
Enumeration Date:2010-12-09
Last Update Date:2015-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0401412893122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist