# KEVIN L. KLINEDINST DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1417421421
- **Authorized official:** KEVIN L. KLINEDINST DDS (DENTIST)
- **Authorized official phone:** (812) 273-4524

## Contact information

- **Practice address:** 110 MILES RIDGE RD, MADISON, IN 47250-2410
- **Practice address phone:** (812) 273-4524
- **Mailing address:** 110 MILES RIDGE RD, MADISON, IN 47250-2410
- **Mailing address phone:** (812) 273-4524

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | — | NULL | Yes |

## Other

- **Enumeration date:** 01/14/2019
- **Last updated:** 01/14/2019

## Other identifiers

| Code | Description | Identifier | Issuer | State |
| --- | --- | --- | --- | --- |
| 05 | — | 100148910A | — | IN |