Organization
STATE STREET DENTISTRY PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MS. NATALIE MARIE KLUMP (GENERAL MANAGER)
(812) 431-2201
Entity
Organization
Contact information
Practice address
333C STATE ST, NEWBURGH, IN 47630-1231
(812) 853-3344
(812) 853-3370
Mailing address
333C STATE ST, NEWBURGH, IN 47630-1231
(812) 853-3344
(812) 853-3370
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12006732
IN
Other
Enumeration date
07/26/2011
Last updated
07/26/2011
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