Healthcare Provider Details

I. General information

NPI: 1700369105
Provider Name (Legal Business Name): SPRING KLEIN ENDODONTICS PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/11/2018
Last Update Date: 09/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6078 FM 2920 RD
SPRING TX
77379-2542
US

IV. Provider business mailing address

6078 FM 2920 RD
SPRING TX
77379-2542
US

V. Phone/Fax

Practice location:
  • Phone: 281-516-8049
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223E0200X
TaxonomyEndodontics
License Number
License Number State

VIII. Authorized Official

Name: JULIA GUTIERREZ
Title or Position: MANAGER
Credential:
Phone: 281-516-8049