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General NPI Number Information
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NPI Number | 1902415912
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Entity Type | Organization
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Legal Business Name | ALEXIS KLASSEN & ASSOCIATES DDS, LLC
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Dates
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Enumeration Date | 07/26/2020
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Last Update Date | 07/26/2020
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Provider Practice Location Address
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Address Line | 1218 RIDGEWOOD DR
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2664
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Country | US
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Telephone | 419-352-2371
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Fax |
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Provider Business Mailing Address
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Address Line | 1218 RIDGEWOOD DR
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City | BOWLING GREEN
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State | OH
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Zip | 43402-2664
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Country | US
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Telephone | 419-352-2371
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Fax |
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Authorized Official
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Title or Position | OWNER, DENTIST
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Name | ALEXIS CECELIAMARIE KLASSEN
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Credential | DDS
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Telephone | 419-352-2371
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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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