Individual
DR. CHARLES B KLEMZ
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1383 21ST AVE N, SUITE B, FARGO, ND 58102-1841
(701) 237-3517
(701) 293-9718
Mailing address
1383 21ST AVE N, SUITE B, FARGO, ND 58102-1841
(701) 237-3517
(701) 293-9718
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1545
ND
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
040591
—
ND
01
—
1545
DSC PROVIDER NUMBER
ND
Enumeration date
09/12/2006
Last updated
03/07/2023
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