Healthcare Provider Details

I. General information

NPI: 1104931781
Provider Name (Legal Business Name): STEVEN MARK KLAYMAN DDS MS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/21/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1925 E DUBLIN GRANVILLE RD
COLUMBUS OH
43229
US

IV. Provider business mailing address

987 PROPRIETORS RD
WORTHINGTON OH
43085
US

V. Phone/Fax

Practice location:
  • Phone: 614-846-5273
  • Fax:
Mailing address:
  • Phone: 614-854-0107
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number13902
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: