MEDICARE: DR. TREVOR KLEIN DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	9196	SC

General Provider Information

NPI Number	:	1619449121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. TREVOR KLEIN DDS

Provider Business Mailing Address
First Line	:	8400 BRIDGESTONE DR
Second Line	:
City	:	HUNTERSVILLE
State	:	NC
Zip	:	28078-5835
Country	:	US
Telephone Number	:	607-743-2520
Fax Number	:

Provider Business Practice Location Address
First Line	:	1578 CONSTITUTION BLVD STE 1
Second Line	:
City	:	ROCK HILL
State	:	SC
Zip	:	29732-3544
Country	:	US
Telephone Number	:	607-743-2520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/21/2018
Last Update Date	:	02/01/2024

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