Provider Demographics
NPI:1750362414
Name:KLEIN, KATHERINE PENNINGTON (DMD, MS)
Entity type:Individual
Prefix:DR
First Name:KATHERINE
Middle Name:PENNINGTON
Last Name:KLEIN
Suffix:
Gender:F
Credentials:DMD, MS
Other - Prefix:DR
Other - First Name:KATHERINE
Other - Middle Name:MARY
Other - Last Name:PENNINGTON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DMD
Mailing Address - Street 1:40 EATON RD
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-3304
Mailing Address - Country:US
Mailing Address - Phone:215-901-1119
Mailing Address - Fax:
Practice Address - Street 1:165 CAMBRIDGE ST
Practice Address - Street 2:SUITE 401
Practice Address - City:BOSTON
Practice Address - State:MA
Practice Address - Zip Code:02114-2783
Practice Address - Country:US
Practice Address - Phone:617-726-1076
Practice Address - Fax:617-724-6681
Is Sole Proprietor?:No
Enumeration Date:2005-11-09
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MADN18556261223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics