Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0221X | Pediatric Dentist | 06060 | MD |
NPI | 1053426361 |
---|---|
Provider Name | Dr. Richard Alan Kline |
First Address | Baltimore, MD 21234 |
Second Address | Baltimore, MD 21234 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/08/2006 |
Last Update Date | 08/07/2007 |