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General NPI Number Information
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NPI Number | 1205027695
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Entity Type | Organization
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Legal Business Name | KENNETH M. KLAMUT, DDS, PC
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Dates
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Enumeration Date | 08/09/2007
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Last Update Date | 08/09/2007
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Provider Practice Location Address
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Address Line | 129 UNIVERSITY BLVD SUITE A
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City | HARRISONBURG
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State | VA
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Zip | 22801-3751
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Country | US
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Telephone | 540-432-1300
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Fax | 540-438-0811
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Provider Business Mailing Address
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Address Line | 129 UNIVERSITY BLVD SUITE A
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City | HARRISONBURG
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State | VA
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Zip | 22801-3751
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Country | US
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Telephone | 540-432-1300
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Fax | 540-438-0811
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. KENNETH M. KLAMUT
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Credential | DDS
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Telephone | 540-432-1300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223S0112X
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Taxonomy Name | Oral and Maxillofacial Surgery (Dentist)
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License Number | 0401007080
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License Number State | VA
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