Provider Demographics
NPI:1023096617
Name:KLEIN, KANDEE KAE (DDS PA)
Entity type:Individual
Prefix:DR
First Name:KANDEE
Middle Name:KAE
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:801 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:GARDEN CITY
Mailing Address - State:KS
Mailing Address - Zip Code:67846-5436
Mailing Address - Country:US
Mailing Address - Phone:620-260-9020
Mailing Address - Fax:620-260-9119
Practice Address - Street 1:301 N MAIN STREET
Practice Address - Street 2:
Practice Address - City:GARDEN CITY
Practice Address - State:KS
Practice Address - Zip Code:67846-5436
Practice Address - Country:US
Practice Address - Phone:620-260-9020
Practice Address - Fax:620-260-9119
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6606122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
1005564OtherHEALTHCARE DORAL