1639212525 NPI number — DR. MICHELLE FRANCISCO KLINE DMD

Table of content: DR. MICHELLE FRANCISCO KLINE DMD (NPI 1639212525)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1639212525 NPI number — DR. MICHELLE FRANCISCO KLINE DMD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KLINE
Provider First Name:
MICHELLE
Provider Middle Name:
FRANCISCO
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DMD
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
FRANCISCO
Provider Other First Name:
MICHELLE
Provider Other Middle Name:
CASIANO
Provider Other Name Prefix Text:
DR.
Provider Other Name Suffix Text:
Provider Other Credential Text:
DMD
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1639212525
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/07/2011
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
154 WALLACE AVE
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
DOWNINGTOWN
Provider Business Mailing Address State Name:
PA
Provider Business Mailing Address Postal Code:
19335-2643
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
610-873-9744
Provider Business Mailing Address Fax Number:
610-873-3009

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
154 WALLACE AVE
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
DOWNINGTOWN
Provider Business Practice Location Address State Name:
PA
Provider Business Practice Location Address Postal Code:
19335-2643
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
610-873-9744
Provider Business Practice Location Address Fax Number:
610-873-3009
Provider Enumeration Date:
02/14/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 122300000X , with the licence number:  DS035956 , registered in the state of PA ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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