Provider Demographics
NPI:1689666851
Name:KNAPP, K. BRAD (DDS)
Entity Type:Individual
Prefix:DR
First Name:K.
Middle Name:BRAD
Last Name:KNAPP
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1422 EUCLID AVE
Mailing Address - Street 2:HANNA BLDG. SUITE 612
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44115-1902
Mailing Address - Country:US
Mailing Address - Phone:216-241-6104
Mailing Address - Fax:216-241-5745
Practice Address - Street 1:1422 EUCLID AVE
Practice Address - Street 2:HANNA BLDG. SUITE 612
Practice Address - City:CLEVELAND
Practice Address - State:OH
Practice Address - Zip Code:44115-1902
Practice Address - Country:US
Practice Address - Phone:216-241-6104
Practice Address - Fax:216-241-5745
Is Sole Proprietor?:No
Enumeration Date:2005-08-16
Last Update Date:2014-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30-01-7067122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist