Provider Demographics
NPI:1104914241
Name:KLOMPARENS, ROBERT WAYNE (DDS, MS)
Entity type:Individual
Prefix:DR
First Name:ROBERT
Middle Name:WAYNE
Last Name:KLOMPARENS
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Gender:M
Credentials:DDS, MS
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Mailing Address - Street 1:810 W WACKERLY ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4716
Mailing Address - Country:US
Mailing Address - Phone:989-631-9860
Mailing Address - Fax:989-631-3996
Practice Address - Street 1:810 W WACKERLY ST
Practice Address - Street 2:SUITE A
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-4716
Practice Address - Country:US
Practice Address - Phone:989-631-9860
Practice Address - Fax:989-631-3996
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MI120951223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics