Provider Demographics
NPI:1477650992
Name:J. C. KLINE, D.D.S., INC
Entity Type:Organization
Organization Name:J. C. KLINE, D.D.S., INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:C
Authorized Official - Last Name:KLINE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:330-644-8423
Mailing Address - Street 1:2800 S. ARLINGTON RD.
Mailing Address - Street 2:SUITE 103
Mailing Address - City:AKRON
Mailing Address - State:OH
Mailing Address - Zip Code:44312
Mailing Address - Country:US
Mailing Address - Phone:330-644-8423
Mailing Address - Fax:330-644-0884
Practice Address - Street 1:2800 S. ARLINGTON RD.
Practice Address - Street 2:SUITE 103
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44312
Practice Address - Country:US
Practice Address - Phone:330-644-8423
Practice Address - Fax:330-644-0884
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-19
Last Update Date:2008-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH144401223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH=========OtherTAX ID NUMBER