Provider Demographics
NPI:1316302458
Name:KLINK, D.M.D., JEFFREY (DMD)
Entity type:Individual
Prefix:DR
First Name:JEFFREY
Middle Name:
Last Name:KLINK, D.M.D.
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20397 ROUTE 19 STE 232
Mailing Address - Street 2:
Mailing Address - City:CRANBERRY TOWNSHIP
Mailing Address - State:PA
Mailing Address - Zip Code:16066-6133
Mailing Address - Country:US
Mailing Address - Phone:724-776-0011
Mailing Address - Fax:724-776-0047
Practice Address - Street 1:20397 ROUTE 19 STE 232
Practice Address - Street 2:
Practice Address - City:CRANBERRY TOWNSHIP
Practice Address - State:PA
Practice Address - Zip Code:16066-6133
Practice Address - Country:US
Practice Address - Phone:724-776-0011
Practice Address - Fax:724-776-0047
Is Sole Proprietor?:No
Enumeration Date:2015-12-16
Last Update Date:2015-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS-025920-L122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist