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General NPI Number Information
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NPI Number | 1689828055
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Entity Type | Organization
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Legal Business Name | RUDOLPH E. KLIMA JR. D.D.S., P.A.
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Dates
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Enumeration Date | 11/11/2008
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Last Update Date | 11/11/2008
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Provider Practice Location Address
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Address Line | 4519 LOWER BECKLEYSVILLE RD
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2613
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Country | US
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Telephone | 410-374-9066
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Fax | 410-374-0783
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Provider Business Mailing Address
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Address Line | 4519 LOWER BECKLEYSVILLE RD
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City | HAMPSTEAD
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State | MD
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Zip | 21074-2613
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Country | US
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Telephone | 410-374-9066
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Fax | 410-374-0783
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Authorized Official
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Title or Position | OWNER
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Name | DR. RUDOLPH EDWARD KLIMA JR.
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Credential | D.D.S.
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Telephone | 410-474-9066
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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 | 9905
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License Number State | MD
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