Individual
JONI L. KLUTH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
2204 S PARK AVE, ALEXANDRIA, IN 46001-8059
(765) 724-7729
Mailing address
7231 OAK COVE LN, NOBLESVILLE, IN 46062-9415
(317) 877-0420
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009300
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000189293
ANTHEM BLUE CROSS
IN
Enumeration date
02/12/2007
Last updated
07/08/2007
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