Individual
DR. RYAN E KLOBOVES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
5457 WEST 38TH STREET, INDIANAPOLIS, IN 46254
(317) 291-9000
Mailing address
12073 FLAGSTONE DRIVE, FISHERS, IN 46037
(317) 578-0085
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12010746B
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200522010
—
IN
Enumeration date
01/18/2007
Last updated
07/08/2007
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