Provider Demographics
NPI:1013065515
Name:RATH, MARY KLUENER (DDS)
Entity Type:Individual
Prefix:DR
First Name:MARY
Middle Name:KLUENER
Last Name:RATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5597 SQUIRREL RUN LANE
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45247
Mailing Address - Country:US
Mailing Address - Phone:513-741-3848
Mailing Address - Fax:
Practice Address - Street 1:1149 STONE DR
Practice Address - Street 2:300
Practice Address - City:HARRISON
Practice Address - State:OH
Practice Address - Zip Code:45030-2763
Practice Address - Country:US
Practice Address - Phone:513-367-0113
Practice Address - Fax:513-367-4574
Is Sole Proprietor?:No
Enumeration Date:2007-01-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH300160821223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice