Healthcare Provider Details

I. General information

NPI: 1861805061
Provider Name (Legal Business Name): V JUNIA KLATT R.D.H.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/05/2014
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

228 S 18TH AVE
STURGEON BAY WI
54235-1000
US

IV. Provider business mailing address

141 N 9TH AVE
STURGEON BAY WI
54235-1729
US

V. Phone/Fax

Practice location:
  • Phone: 920-746-3788
  • Fax:
Mailing address:
  • Phone: 720-318-3839
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code124Q00000X
TaxonomyDental Hygienist
License Number1003549-16
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: