Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 122300000X | Dentist | 1002388 | NH |
NPI | 1003997917 |
---|---|
Provider Name | Dr. Eugene Jay Klein |
First Address | Keene, NH 03431 |
Second Address | Keene, NH 03431 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 18/10/2006 |
Last Update Date | 08/07/2007 |