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Individual
MICHAEL K. KLUTH
Active
Individual
MICHAEL K. KLUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009126
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000089901
ANTHEM BLUE CROSS
IN
01
—
784991
ARMED FORCES
IN
05
—
9177506
—
IL
Enumeration date
02/12/2007
Last updated
07/08/2007
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