MEDICARE: MITCHELL J. KLEIN DDS PA

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	13381	FL

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1093872152
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	MITCHELL J. KLEIN DDS PA

Provider Business Mailing Address
First Line	:	7228 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1041
Country	:	US
Telephone Number	:	954-748-4860
Fax Number	:

Provider Business Practice Location Address
First Line	:	7228 W OAKLAND PARK BLVD
Second Line	:
City	:	LAUDERHILL
State	:	FL
Zip	:	33313-1041
Country	:	US
Telephone Number	:	954-748-4860
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. MITCHELL J KLEIN
Credential	:	DDS
Telephone Number	:	954-748-4860

Provider Enumeration Date	:	01/01/2007
Last Update Date	:	06/17/2008

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