Provider Demographics
NPI:1609124999
Name:KLASSY, DEAN M SR
Entity Type:Individual
Prefix:MR
First Name:DEAN
Middle Name:M
Last Name:KLASSY
Suffix:SR
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1515 EUBANK BLVD
Mailing Address - Street 2:BLDG 831/831
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87185-1019
Mailing Address - Country:US
Mailing Address - Phone:505-844-4237
Mailing Address - Fax:
Practice Address - Street 1:1515 EUBANK BLVD
Practice Address - Street 2:BLDG 831/831
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87185-1019
Practice Address - Country:US
Practice Address - Phone:505-844-4237
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-08-17
Last Update Date:2012-08-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247200000XTechnologists, Technicians & Other Technical Service ProvidersTechnician, Other