Provider Demographics
NPI:1346392487
Name:MICHAEL E KLEINMAN DMD PC
Entity Type:Organization
Organization Name:MICHAEL E KLEINMAN DMD PC
Other - Org Name:SOUDERTON DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:E
Authorized Official - Last Name:KLEINMAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:215-723-3674
Mailing Address - Street 1:231 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:SOUDERTON
Mailing Address - State:PA
Mailing Address - Zip Code:18964
Mailing Address - Country:US
Mailing Address - Phone:215-723-3674
Mailing Address - Fax:215-723-5132
Practice Address - Street 1:231 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:SOUDERTON
Practice Address - State:PA
Practice Address - Zip Code:18964
Practice Address - Country:US
Practice Address - Phone:215-723-3674
Practice Address - Fax:215-723-5132
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-17
Last Update Date:2008-08-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS028679L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty