Provider Demographics
NPI:1225053713
Name:KLEMM, BARRETT R (DDS)
Entity Type:Individual
Prefix:DR
First Name:BARRETT
Middle Name:R
Last Name:KLEMM
Suffix:
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 1:115 E E ST
Mailing Address - Street 2:P O BOX 1029
Mailing Address - City:NORTH PLATTE
Mailing Address - State:NE
Mailing Address - Zip Code:69101-5535
Mailing Address - Country:US
Mailing Address - Phone:308-532-9690
Mailing Address - Fax:308-532-8949
Practice Address - Street 1:115 E E ST
Practice Address - Street 2:
Practice Address - City:NORTH PLATTE
Practice Address - State:NE
Practice Address - Zip Code:69101-5535
Practice Address - Country:US
Practice Address - Phone:308-532-9690
Practice Address - Fax:308-532-8949
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE56861223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice