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Organization

MAGGIE A KLEEM DDS LLC

Active
Parent organization
MAGGIE A KLEEM DDS
Organization subpart
Yes

Provider details

NPI number
Legal business name
MAGGIE A KLEEM DDS
Authorized official
MAGGIE KLEEM (OWNER)
(440) 239-8389
Entity
Organization

Contact information

Practice address
352 W BAGLEY RD, BEREA, OH 44017-1348
(440) 239-8389
Mailing address
352 W BAGLEY RD, BEREA, OH 44017-1348
(440) 239-8389

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
30-021064
OH

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
1740335595
DENTIST
OH
Enumeration date
06/09/2016
Last updated
06/09/2016
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