Provider Demographics
NPI:1396790630
Name:KLEMMA, ASLE TAYLOR (DDS)
Entity type:Individual
Prefix:DR
First Name:ASLE
Middle Name:TAYLOR
Last Name:KLEMMA
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 1:5526 CHILDS AVE
Mailing Address - Street 2:
Mailing Address - City:HINSDALE
Mailing Address - State:IL
Mailing Address - Zip Code:60521-5005
Mailing Address - Country:US
Mailing Address - Phone:630-325-4766
Mailing Address - Fax:
Practice Address - Street 1:140 S ROSELLE RD
Practice Address - Street 2:SUITE D
Practice Address - City:SCHAUMBURG
Practice Address - State:IL
Practice Address - Zip Code:60193-5594
Practice Address - Country:US
Practice Address - Phone:847-895-8565
Practice Address - Fax:847-895-1307
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice