Organization
KEVIN L. KLINEDINST DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KEVIN L. KLINEDINST DDS (DENTIST)
(812) 273-4524
Entity
Organization
Contact information
Practice address
110 MILES RIDGE RD, MADISON, IN 47250-2410
(812) 273-4524
Mailing address
110 MILES RIDGE RD, MADISON, IN 47250-2410
(812) 273-4524
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100148910A
—
IN
Enumeration date
01/14/2019
Last updated
01/14/2019
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