Provider Demographics
NPI:1992152805
Name:AREND KLOOSTER DDS, PLLC
Entity type:Organization
Organization Name:AREND KLOOSTER DDS, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:AREND
Authorized Official - Middle Name:
Authorized Official - Last Name:KLOOSTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:919-362-1394
Mailing Address - Street 1:100 HYANNIS DR
Mailing Address - Street 2:
Mailing Address - City:HOLLY SPRINGS
Mailing Address - State:NC
Mailing Address - Zip Code:27540-8327
Mailing Address - Country:US
Mailing Address - Phone:919-362-1394
Mailing Address - Fax:
Practice Address - Street 1:100 HYANNIS DR
Practice Address - Street 2:
Practice Address - City:HOLLY SPRINGS
Practice Address - State:NC
Practice Address - Zip Code:27540-8327
Practice Address - Country:US
Practice Address - Phone:919-362-1394
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty