Provider Demographics
NPI:1619989563
Name:KLIMCAK, CASS F (DMD)
Entity Type:Individual
Prefix:DR
First Name:CASS
Middle Name:F
Last Name:KLIMCAK
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 EAGLE POINT CORPORATE DR STE 102
Mailing Address - Street 2:
Mailing Address - City:BIRMINGHAM
Mailing Address - State:AL
Mailing Address - Zip Code:35242-6995
Mailing Address - Country:US
Mailing Address - Phone:205-981-9449
Mailing Address - Fax:205-981-9062
Practice Address - Street 1:1000 EAGLE POINT CORPORATE DR STE 102
Practice Address - Street 2:
Practice Address - City:BIRMINGHAM
Practice Address - State:AL
Practice Address - Zip Code:35242-6995
Practice Address - Country:US
Practice Address - Phone:205-981-9449
Practice Address - Fax:205-981-9062
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL50811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice