Provider Demographics
NPI:1750795530
Name:KLETTER D.M.D & LEVINE D.D.S. PC
Entity type:Organization
Organization Name:KLETTER D.M.D & LEVINE D.D.S. PC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MS
Authorized Official - First Name:HEIDI
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:HANNA
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:518-630-5420
Mailing Address - Street 1:945 ROUTE 146
Mailing Address - Street 2:SUITE 100
Mailing Address - City:CLIFTON PARK
Mailing Address - State:NY
Mailing Address - Zip Code:12065-3649
Mailing Address - Country:US
Mailing Address - Phone:518-630-5420
Mailing Address - Fax:518-630-5422
Practice Address - Street 1:983 ROUTE 146
Practice Address - Street 2:
Practice Address - City:CLIFTON PARK
Practice Address - State:NY
Practice Address - Zip Code:12065-3616
Practice Address - Country:US
Practice Address - Phone:518-371-3333
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:KLETTER D.M.D & LEVINE D.D.S. PC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2014-06-19
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0300XDental ProvidersDentistPeriodonticsGroup - Single Specialty