Provider Demographics
NPI:1164153938
Name:KLEINE, THOMAS CHANDLER JR (DDS)
Entity Type:Individual
Prefix:DR
First Name:THOMAS
Middle Name:CHANDLER
Last Name:KLEINE
Suffix:JR
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2920 W 29TH AVE APT 208
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80211-4594
Mailing Address - Country:US
Mailing Address - Phone:757-763-8440
Mailing Address - Fax:
Practice Address - Street 1:5104 S FIELD ST
Practice Address - Street 2:
Practice Address - City:LITTLETON
Practice Address - State:CO
Practice Address - Zip Code:80123-7329
Practice Address - Country:US
Practice Address - Phone:303-647-9085
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-22
Last Update Date:2022-06-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CODEN.002051751223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice