Provider Demographics
NPI:1245247345
Name:KLUGMAN, GARY PHILLIP (DDS)
Entity type:Individual
Prefix:
First Name:GARY
Middle Name:PHILLIP
Last Name:KLUGMAN
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 1:935 BLANCO CIR
Mailing Address - Street 2:
Mailing Address - City:SALINAS
Mailing Address - State:CA
Mailing Address - Zip Code:93901-4446
Mailing Address - Country:US
Mailing Address - Phone:831-422-7838
Mailing Address - Fax:831-422-1007
Practice Address - Street 1:935 BLANCO CIR
Practice Address - Street 2:
Practice Address - City:SALINAS
Practice Address - State:CA
Practice Address - Zip Code:93901-4446
Practice Address - Country:US
Practice Address - Phone:831-422-7838
Practice Address - Fax:831-422-1007
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA261921223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice