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General NPI Number Information
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NPI Number | 1750795530
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Entity Type | Organization
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Legal Business Name | KLETTER D.M.D & LEVINE D.D.S. PC
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Dates
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Enumeration Date | 06/19/2014
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Last Update Date | 07/02/2014
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Provider Practice Location Address
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Address Line | 983 ROUTE 146
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3616
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Country | US
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Telephone | 518-371-3333
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Fax |
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Provider Business Mailing Address
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Address Line | 945 ROUTE 146 SUITE 100
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3649
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Country | US
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Telephone | 518-630-5420
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Fax | 518-630-5422
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Authorized Official
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Title or Position | OFFICE MANAGER
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Name | MS. HEIDI MARIE HANNA
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Credential |
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Telephone | 518-630-5420
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number |
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License Number State |
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