Provider Demographics
NPI:1801048194
Name:KLEIN, EDWARD JOSEPH (DMD)
Entity type:Individual
Prefix:DR
First Name:EDWARD
Middle Name:JOSEPH
Last Name:KLEIN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1120 RARITAN RD
Mailing Address - Street 2:
Mailing Address - City:CLARK
Mailing Address - State:NJ
Mailing Address - Zip Code:07066-1329
Mailing Address - Country:US
Mailing Address - Phone:732-382-7311
Mailing Address - Fax:
Practice Address - Street 1:1120 RARITAN RD
Practice Address - Street 2:
Practice Address - City:CLARK
Practice Address - State:NJ
Practice Address - Zip Code:07066-1329
Practice Address - Country:US
Practice Address - Phone:732-382-7311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-10-17
Last Update Date:2008-10-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ22DI008300001223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice