Provider Demographics
NPI:1235374042
Name:KLEMENT, MINDY RENEE (DDS)
Entity Type:Individual
Prefix:DR
First Name:MINDY
Middle Name:RENEE
Last Name:KLEMENT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:MINDY
Other - Middle Name:
Other - Last Name:GRAHAM
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:PO BOX 709
Mailing Address - Street 2:
Mailing Address - City:MUENSTER
Mailing Address - State:TX
Mailing Address - Zip Code:76252-0709
Mailing Address - Country:US
Mailing Address - Phone:940-759-2239
Mailing Address - Fax:940-759-4777
Practice Address - Street 1:419 N. MAPLE
Practice Address - Street 2:
Practice Address - City:MUENSTER
Practice Address - State:TX
Practice Address - Zip Code:76252
Practice Address - Country:US
Practice Address - Phone:940-759-2239
Practice Address - Fax:940-759-4777
Is Sole Proprietor?:No
Enumeration Date:2008-12-08
Last Update Date:2014-12-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX20103122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist