Provider Demographics
NPI:1689799322
Name:KLUEMPER, M JOAN (DMD)
Entity Type:Individual
Prefix:MS
First Name:M
Middle Name:JOAN
Last Name:KLUEMPER
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 1:1636 NICHOLASVILLE RD
Mailing Address - Street 2:SUITE 4
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40503
Mailing Address - Country:US
Mailing Address - Phone:859-276-3624
Mailing Address - Fax:859-276-3314
Practice Address - Street 1:1636 NICHOLASVILLE RD
Practice Address - Street 2:SUITE 4
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503
Practice Address - Country:US
Practice Address - Phone:859-276-3624
Practice Address - Fax:859-276-3314
Is Sole Proprietor?:No
Enumeration Date:2007-03-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY46051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice