Provider Demographics
NPI:1992714273
Name:KLEINSASSER, RICK J (DDS)
Entity type:Individual
Prefix:
First Name:RICK
Middle Name:J
Last Name:KLEINSASSER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1430 E MAIN ST STE 203
Mailing Address - Street 2:
Mailing Address - City:SANTA MARIA
Mailing Address - State:CA
Mailing Address - Zip Code:93454-4832
Mailing Address - Country:US
Mailing Address - Phone:805-922-3530
Mailing Address - Fax:805-928-4776
Practice Address - Street 1:1430 E MAIN ST STE 203
Practice Address - Street 2:
Practice Address - City:SANTA MARIA
Practice Address - State:CA
Practice Address - Zip Code:93454-4832
Practice Address - Country:US
Practice Address - Phone:805-922-3530
Practice Address - Fax:805-928-4776
Is Sole Proprietor?:No
Enumeration Date:2006-08-05
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA293301223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice