Provider Demographics
NPI:1700958006
Name:KLEINER, ROBERT MARC (DDS)
Entity Type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:MARC
Last Name:KLEINER
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 1:320 THE CLFS
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30350-2623
Mailing Address - Country:US
Mailing Address - Phone:770-641-1666
Mailing Address - Fax:
Practice Address - Street 1:4122 E PONCE DE LEON AVE
Practice Address - Street 2:SUITE #5
Practice Address - City:CLARKSTON
Practice Address - State:GA
Practice Address - Zip Code:30021-1838
Practice Address - Country:US
Practice Address - Phone:404-294-8385
Practice Address - Fax:404-294-4000
Is Sole Proprietor?:No
Enumeration Date:2006-11-14
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0086831223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice