Provider Demographics
NPI:1417003542
Name:KLINE, ROSS E (DMD)
Entity Type:Individual
Prefix:DR
First Name:ROSS
Middle Name:E
Last Name:KLINE
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3825 LINGLESTOWN RD
Mailing Address - Street 2:
Mailing Address - City:HARRISBURG
Mailing Address - State:PA
Mailing Address - Zip Code:17110-3631
Mailing Address - Country:US
Mailing Address - Phone:717-652-3887
Mailing Address - Fax:717-652-9509
Practice Address - Street 1:3825 LINGLESTOWN RD
Practice Address - Street 2:
Practice Address - City:HARRISBURG
Practice Address - State:PA
Practice Address - Zip Code:17110-3631
Practice Address - Country:US
Practice Address - Phone:717-652-3887
Practice Address - Fax:717-652-9509
Is Sole Proprietor?:No
Enumeration Date:2007-01-25
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS024490L1223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA535995OtherPROVIDER # UCCI