MEDICARE: SPRING KLEIN ENDODONTICS PLLC

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	1223E0200X	Endodontics

General Provider Information

NPI Number	:	1700369105
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPRING KLEIN ENDODONTICS PLLC

Provider Business Mailing Address
First Line	:	6078 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2542
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	6078 FM 2920 RD
Second Line	:
City	:	SPRING
State	:	TX
Zip	:	77379-2542
Country	:	US
Telephone Number	:	281-516-8049
Fax Number	:

Authorized Official
Title or Position	:	MANAGER
Name	:	JULIA GUTIERREZ
Credential	:
Telephone Number	:	281-516-8049

Provider Enumeration Date	:	09/11/2018
Last Update Date	:	09/11/2018

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