Provider Demographics
NPI:1790443653
Name:KLEMZ SCHLICHTING, KATHRYN (DDS, MA)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:
Last Name:KLEMZ SCHLICHTING
Suffix:
Gender:F
Credentials:DDS, MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 NOLEN LN
Mailing Address - Street 2:
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27516-4434
Mailing Address - Country:US
Mailing Address - Phone:954-805-0728
Mailing Address - Fax:
Practice Address - Street 1:385 S COLUMBIA ST
Practice Address - Street 2:
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27599-0001
Practice Address - Country:US
Practice Address - Phone:919-537-3726
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-12-07
Last Update Date:2021-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC002381223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice