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General NPI Number Information
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NPI Number | 1396307187
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Entity Type | Organization
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Legal Business Name | ALBERT E. KLITZKE DDS INC
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Dates
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Enumeration Date | 07/02/2019
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Last Update Date | 07/02/2019
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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 | 619-596-9308
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Provider Business Mailing 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 | 619-596-9308
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. ALBERT E KLITZKE IV
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Credential | DDS
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Telephone | 619-596-0144
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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