Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0106X | Oral and Maxillofacial Pathology | 054300 | NY |
N | 1223P0106X | Oral and Maxillofacial Pathology | D10936 | OR |
NPI | 1710108352 |
---|---|
Provider Name | Dr. David Eric Klingman |
First Address | Jbsa Lackland, TX 78236 |
Second Address | Jbsa Lackland, TX 78236 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/05/2007 |
Last Update Date | 21/04/2021 |