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General NPI Number Information
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NPI Number | 1083606651
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Entity Type | Individual
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Provider Name | ALBERT ERNST KLITZKE DDS
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Gender | Male
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Dates
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Enumeration Date | 08/18/2005
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 8790 CUYAMACA ST STE E
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City | SANTEE
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State | CA
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Zip | 92071-4295
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Country | US
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Telephone | 619-596-0144
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Fax |
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Provider Business Mailing Address
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Address Line | 11717 CALLE TRUCKSESS
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City | EL CAJON
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State | CA
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Zip | 92019-4819
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Country | US
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Telephone | 619-670-6695
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 33433
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License Number State | CA
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