Provider Demographics
NPI:1396853313
Name:SCOTT B. KLIMAJ, DMD
Entity Type:Organization
Organization Name:SCOTT B. KLIMAJ, DMD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:
Authorized Official - Last Name:KLIMAJ
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:401-949-3200
Mailing Address - Street 1:1 GARNETT LN
Mailing Address - Street 2:SUITE 8
Mailing Address - City:GREENVILLE
Mailing Address - State:RI
Mailing Address - Zip Code:02828-1414
Mailing Address - Country:US
Mailing Address - Phone:401-949-3200
Mailing Address - Fax:401-949-5213
Practice Address - Street 1:1 GARNETT LN
Practice Address - Street 2:SUITE 8
Practice Address - City:GREENVILLE
Practice Address - State:RI
Practice Address - Zip Code:02828-1414
Practice Address - Country:US
Practice Address - Phone:401-949-3200
Practice Address - Fax:401-949-5213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-29
Last Update Date:2008-08-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RI26531223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty