MEDICARE: STEVEN KLINE DDS

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	DN19863	FL

General Provider Information

NPI Number	:	1578818126
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	STEVEN KLINE DDS

Provider Business Mailing Address
First Line	:	883 MILLBRAE CT
Second Line	:	#5
City	:	WEST PALM BEACH
State	:	FL
Zip	:	33401-8467
Country	:	US
Telephone Number	:	772-335-3088
Fax Number	:	773-298-0041

Provider Business Practice Location Address
First Line	:	1202 SE PORT ST LUCIE BLVD
Second Line	:
City	:	PORT SAINT LUCIE
State	:	FL
Zip	:	34952-5364
Country	:	US
Telephone Number	:	772-335-3088
Fax Number	:	772-398-0041

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/19/2012
Last Update Date	:	07/19/2012

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