Provider Demographics
NPI:1568728889
Name:KLEMP FAMILY DENTISTRY
Entity Type:Organization
Organization Name:KLEMP FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DENNIS
Authorized Official - Middle Name:M
Authorized Official - Last Name:KLEMP
Authorized Official - Suffix:
Authorized Official - Credentials:DMD FAGD
Authorized Official - Phone:503-468-0116
Mailing Address - Street 1:1006 W MARINE DR
Mailing Address - Street 2:
Mailing Address - City:ASTORIA
Mailing Address - State:OR
Mailing Address - Zip Code:97103-5826
Mailing Address - Country:US
Mailing Address - Phone:503-468-0116
Mailing Address - Fax:
Practice Address - Street 1:1006 W MARINE DR
Practice Address - Street 2:
Practice Address - City:ASTORIA
Practice Address - State:OR
Practice Address - Zip Code:97103-5826
Practice Address - Country:US
Practice Address - Phone:503-468-0116
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2012-04-11
Last Update Date:2012-04-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty