Robert Marc Kleiner, DDS

Individual provider Active NPI General Practice Dentistry · Clarkston, GA

NPI 1700958006 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1700958006
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
DN008683 (GA)
Practice address
4122 E Ponce de Leon Ave
Suite #5
Clarkston, GA 30021-1838
Phone
(404) 294-8385
Fax
(404) 294-4000
NPI assigned
Nov 14, 2006
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
DN008683GAMDGeneral Practice Dentistry

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X DN008683 GA Yes

Addresses

Primary practice location

4122 E Ponce de Leon Ave
Suite #5
Clarkston, GA 30021-1838

Mailing address

320 The CLFS
Atlanta, GA 30350-2623
Phone (770) 641-1666

Other providers in Clarkston, GA

All providers in Clarkston, GA · General Practice Dentistry in Georgia

Sources for this page

Verify at the official NPI Registry.