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General NPI Number Information
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NPI Number | 1902379571
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Entity Type | Organization
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Legal Business Name | RYAN W. KLOHR, DMD, LLC
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Dates
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Enumeration Date | 01/07/2019
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Last Update Date | 01/07/2019
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Provider Practice Location Address
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Address Line | 34 GRAVOIS STA
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City | HOUSE SPRINGS
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State | MO
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Zip | 63051-4348
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Country | US
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Telephone | 636-671-0110
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Fax | 636-671-0332
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Provider Business Mailing Address
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Address Line | 34 GRAVOIS STA
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City | HOUSE SPRINGS
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State | MO
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Zip | 63051-4348
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Country | US
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Telephone | 636-671-0110
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Fax | 636-671-0332
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Authorized Official
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Title or Position | OWNER/DENTIST
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Name | RYAN W KLOHR
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Credential |
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Telephone | 636-671-0110
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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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