MEDICARE: DR. ALEX M KLUEMPER DMD, MS

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	1223X0400X	Orthodontics and Dentofacial Orthopedics Dentistry	30.026554	OH

General Provider Information

NPI Number	:	1598592974
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ALEX M KLUEMPER DMD, MS

Provider Business Mailing Address
First Line	:	41 SPANGLER CT
Second Line	:
City	:	GRANVILLE
State	:	OH
Zip	:	43023-9557
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	1590 COSHOCTON AVE
Second Line	:
City	:	MOUNT VERNON
State	:	OH
Zip	:	43050-1558
Country	:	US
Telephone Number	:	740-397-2111
Fax Number	:

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

Provider Enumeration Date	:	09/18/2024
Last Update Date	:	09/18/2024

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