Provider Demographics
NPI:1801180971
Name:KLUMB, ERIC ROBERT (DDS)
Entity type:Individual
Prefix:DR
First Name:ERIC
Middle Name:ROBERT
Last Name:KLUMB
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 1:18 HILLTOP VILLAGE CENTER DR
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:MO
Mailing Address - Zip Code:63025-3921
Mailing Address - Country:US
Mailing Address - Phone:636-938-6241
Mailing Address - Fax:636-938-7941
Practice Address - Street 1:18 HILLTOP VILLAGE CENTER DR
Practice Address - Street 2:
Practice Address - City:EUREKA
Practice Address - State:MO
Practice Address - Zip Code:63025-3921
Practice Address - Country:US
Practice Address - Phone:636-938-6241
Practice Address - Fax:636-938-7941
Is Sole Proprietor?:Yes
Enumeration Date:2011-06-06
Last Update Date:2011-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO2011015040122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist