Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 7779 | KY |
NPI | 1043353964 |
---|---|
Provider Name | Dr. Donna S Klein |
First Address | Winchester, KY 40391-2387 |
Second Address | Winchester, KY 40391-2387 |
Gender | F |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 14/02/2007 |
Last Update Date | 18/09/2018 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
60001575 | (05) | KY |