Provider Demographics
NPI:1932307105
Name:SCOTT D KLOHR DMD LLC
Entity Type:Organization
Organization Name:SCOTT D KLOHR DMD LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:DOUGLAS
Authorized Official - Last Name:KLOHR
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:314-645-1225
Mailing Address - Street 1:1608 S BIG BEND BLVD
Mailing Address - Street 2:
Mailing Address - City:SAINT LOUIS
Mailing Address - State:MO
Mailing Address - Zip Code:63117-2208
Mailing Address - Country:US
Mailing Address - Phone:314-645-1225
Mailing Address - Fax:314-645-1327
Practice Address - Street 1:1608 S BIG BEND BLVD
Practice Address - Street 2:
Practice Address - City:SAINT LOUIS
Practice Address - State:MO
Practice Address - Zip Code:63117-2208
Practice Address - Country:US
Practice Address - Phone:314-645-1225
Practice Address - Fax:314-645-1327
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-10
Last Update Date:2007-07-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20050260321223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty