MEDICARE: DR. KATHERINE PENNINGTON KLEIN D.M.D., M.S.

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	DN1855626	MA

General Provider Information

NPI Number	:	1750362414
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KATHERINE PENNINGTON KLEIN D.M.D., M.S.

Provider Business Mailing Address
First Line	:	40 EATON RD
Second Line	:
City	:	NEEDHAM
State	:	MA
Zip	:	02492-3304
Country	:	US
Telephone Number	:	215-901-1119
Fax Number	:

Provider Business Practice Location Address
First Line	:	165 CAMBRIDGE ST
Second Line	:	SUITE 401
City	:	BOSTON
State	:	MA
Zip	:	02114-2783
Country	:	US
Telephone Number	:	617-726-1076
Fax Number	:	617-724-6681

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

Provider Enumeration Date	:	11/09/2005
Last Update Date	:	09/24/2021

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