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General NPI Number Information
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NPI Number | 1366283780
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Entity Type | Individual
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Provider Name | DANIELLE KLUTTZ DDS
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Gender | Female
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Dates
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Enumeration Date | 06/03/2024
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Last Update Date | 06/03/2024
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Provider Practice Location Address
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Address Line | 114 WALTER REMLEY DR
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City | CRAWFORDSVILLE
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State | IN
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Zip | 47933-3350
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Country | US
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Telephone | 765-267-8484
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Fax |
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Provider Business Mailing Address
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Address Line | 711 COTTAGE AVE
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City | INDIANAPOLIS
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State | IN
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Zip | 46203-2710
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Country | US
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Telephone |
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12014454A
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License Number State | IN
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