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General NPI Number Information
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NPI Number | 1629719232
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Entity Type | Organization
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Legal Business Name | SAMANTHA KLIPP DDS PLC
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Dates
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Enumeration Date | 04/06/2022
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Last Update Date | 04/06/2022
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Provider Practice Location Address
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Address Line | 526 N MONROE ST
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City | MONROE
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State | MI
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Zip | 48162-2933
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Country | US
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Telephone | 734-241-5254
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Fax | 734-241-1358
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Provider Business Mailing Address
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Address Line | 546 LARKSPUR ST
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City | ANN ARBOR
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State | MI
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Zip | 48105-1163
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Country | US
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Telephone | 734-277-7650
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Fax |
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Authorized Official
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Title or Position | OFFICE MANAGE
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Name | MR. VASANTH KRISHNASWAMI
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Credential |
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Telephone | 734-223-7586
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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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