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General NPI Number Information
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NPI Number | 1629401039
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Entity Type | Individual
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Provider Name | KATIE LYNNE KLAES D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 08/21/2013
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Last Update Date | 12/13/2018
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Provider Practice Location Address
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Address Line | 1460 N GREEN ST SUITE 300
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City | BROWNSBURG
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State | IN
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Zip | 46112-7487
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Country | US
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Telephone | 317-225-4520
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Fax |
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Provider Business Mailing Address
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Address Line | 1460 N GREEN ST SUITE 300
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City | BROWNSBURG
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State | IN
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Zip | 46112-7487
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Country | US
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Telephone | 317-225-4520
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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 | 332B00000X
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Taxonomy Name | Durable Medical Equipment & Medical Supplies
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License Number | 12011983A
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License Number State | IN
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 12011983A
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License Number State | IN
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