Provider Demographics
NPI:1821011149
Name:KLAMPE, TERRY J (DDS, MS)
Entity Type:Individual
Prefix:DR
First Name:TERRY
Middle Name:J
Last Name:KLAMPE
Suffix:
Gender:M
Credentials:DDS, MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2112 VIKING DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-3522
Mailing Address - Country:US
Mailing Address - Phone:507-288-1633
Mailing Address - Fax:507-288-2716
Practice Address - Street 1:2112 VIKING DR NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-3522
Practice Address - Country:US
Practice Address - Phone:507-288-1633
Practice Address - Fax:507-288-2716
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN092491223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice