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Individual

DR. IRA M KLEMONS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DDS PHD

Contact information

Practice address
2045 STATE ROUTE 35, SOUTH AMBOY, NJ 08879-2069
(732) 727-5000
(732) 525-8566
Mailing address
2045 STATE ROUTE 35, SOUTH AMBOY, NJ 08879-2069
(732) 727-5000
(732) 525-8566

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
NJ

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
096787
MEDICARE PIN GROUP #
NJ
01
520804
RENDERING UVE
NJ
01
5530690001
DMEPOS
NJ
Enumeration date
09/07/2006
Last updated
07/08/2007
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