Provider Demographics
NPI:1689828055
Name:RUDOLPH E. KLIMA JR. D.D.S., P.A.
Entity Type:Organization
Organization Name:RUDOLPH E. KLIMA JR. D.D.S., P.A.
Other - Org Name:SMILES BY RK
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RUDOLPH
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KLIMA
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-474-9066
Mailing Address - Street 1:4519 LOWER BECKLEYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2613
Mailing Address - Country:US
Mailing Address - Phone:410-374-9066
Mailing Address - Fax:410-374-0783
Practice Address - Street 1:4519 LOWER BECKLEYSVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2613
Practice Address - Country:US
Practice Address - Phone:410-374-9066
Practice Address - Fax:410-374-0783
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-11-11
Last Update Date:2008-11-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD9905261QD0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental