Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 204E00000X | Oral & Maxillofacial Surgeon | 12010745A | IN |
NPI | 1083757355 |
---|---|
Provider Name | Dr. Carrie A. Klene |
First Address | Carmel, IN 46032-5881 |
Second Address | Carmel, IN 46032-5881 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 23/04/2020 |