Provider Demographics
NPI:1134254808
Name:KLAUSMEYER, WILLIAM B (DDS)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:B
Last Name:KLAUSMEYER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2969 JOHNSON FERRY RD
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30062-5653
Mailing Address - Country:US
Mailing Address - Phone:770-992-2340
Mailing Address - Fax:
Practice Address - Street 1:2969 JOHNSON FERRY RD
Practice Address - Street 2:
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30062-5653
Practice Address - Country:US
Practice Address - Phone:770-992-2340
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-22
Last Update Date:2010-12-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL103251223G0001X
GA0140191223G0001X
MI137671223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice