Provider Demographics
NPI:1861486326
Name:KLEIN, RAYMOND MARTIN (DMD)
Entity Type:Individual
Prefix:DR
First Name:RAYMOND
Middle Name:MARTIN
Last Name:KLEIN
Suffix:
Gender:M
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:PSC 80 BOX 14563
Mailing Address - Street 2:
Mailing Address - City:APO
Mailing Address - State:AP
Mailing Address - Zip Code:96367-0048
Mailing Address - Country:JP
Mailing Address - Phone:315-630-4350
Mailing Address - Fax:
Practice Address - Street 1:PSC 80 BOX 14563
Practice Address - Street 2:
Practice Address - City:APO
Practice Address - State:AP
Practice Address - Zip Code:96367-0048
Practice Address - Country:JP
Practice Address - Phone:315-630-4350
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2005-09-09
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAD232031223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics