MEDICARE: KLEMP FAMILY DENTISTRY

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	1223G0001X	General Practice Dentistry

General Provider Information

NPI Number	:	1568728889
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KLEMP FAMILY DENTISTRY

Provider Business Mailing Address
First Line	:	1006 W MARINE DR
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-5826
Country	:	US
Telephone Number	:	503-468-0116
Fax Number	:

Provider Business Practice Location Address
First Line	:	1006 W MARINE DR
Second Line	:
City	:	ASTORIA
State	:	OR
Zip	:	97103-5826
Country	:	US
Telephone Number	:	503-468-0116
Fax Number	:

Authorized Official
Title or Position	:	DENTIST
Name	:	DR. DENNIS M KLEMP
Credential	:	DMD FAGD
Telephone Number	:	503-468-0116

Provider Enumeration Date	:	04/11/2012
Last Update Date	:	04/11/2012

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Directions to “KLEMP FAMILY DENTISTRY ” Practice Location

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