MEDICARE: DR. DANIEL R KLEIN 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	1223P0221X	Pediatric Dentistry	11584	MI

General Provider Information

NPI Number	:	1760523435
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DANIEL R KLEIN DDS

Provider Business Mailing Address
First Line	:	2121 ABBOTT RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8535
Country	:	US
Telephone Number	:	517-337-0032
Fax Number	:

Provider Business Practice Location Address
First Line	:	2121 ABBOTT RD
Second Line	:
City	:	EAST LANSING
State	:	MI
Zip	:	48823-8535
Country	:	US
Telephone Number	:	517-337-0032
Fax Number	:

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

Provider Enumeration Date	:	02/08/2007
Last Update Date	:	07/08/2007

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