Provider Demographics
NPI:1316984669
Name:HENNETTE & KLEIN D.D.S.,P.C.
Entity type:Organization
Organization Name:HENNETTE & KLEIN D.D.S.,P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HENNETTE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:317-271-9727
Mailing Address - Street 1:7830 ROCKVILLE RD
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46214-3129
Mailing Address - Country:US
Mailing Address - Phone:317-271-9727
Mailing Address - Fax:317-273-2373
Practice Address - Street 1:7830 ROCKVILLE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46214-3129
Practice Address - Country:US
Practice Address - Phone:317-271-9727
Practice Address - Fax:317-273-2373
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-02
Last Update Date:2007-08-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12008107A122300000X
IN12008394A1223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0221XDental ProvidersDentistPediatric DentistryGroup - Multi-Specialty
No122300000XDental ProvidersDentistGroup - Multi-Specialty