Provider Demographics
NPI:1245329002
Name:KLAICH, BRIAN A (DMD)
Entity type:Individual
Prefix:
First Name:BRIAN
Middle Name:A
Last Name:KLAICH
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:ROBERT
Other - Middle Name:M
Other - Last Name:KLAICH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:10011 PENDLETON WAY
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TWP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6900
Mailing Address - Country:US
Mailing Address - Phone:724-776-2280
Mailing Address - Fax:724-776-0242
Practice Address - Street 1:10011 PENDLETON WAY
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6900
Practice Address - Country:US
Practice Address - Phone:724-776-2280
Practice Address - Fax:724-776-0242
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-12
Last Update Date:2024-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS035565122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist