Provider Demographics
NPI:1992803407
Name:KLIMA, RUDOLPH E JR (DDS PA)
Entity type:Individual
Prefix:DR
First Name:RUDOLPH
Middle Name:E
Last Name:KLIMA
Suffix:JR
Gender:M
Credentials:DDS PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4519 LOWER BECKLEYSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:HAMPSTEAD
Mailing Address - State:MD
Mailing Address - Zip Code:21074-2613
Mailing Address - Country:US
Mailing Address - Phone:410-239-9724
Mailing Address - Fax:410-239-1468
Practice Address - Street 1:4519 LOWER BECKLEYSVILLE RD
Practice Address - Street 2:
Practice Address - City:HAMPSTEAD
Practice Address - State:MD
Practice Address - Zip Code:21074-2613
Practice Address - Country:US
Practice Address - Phone:410-239-9724
Practice Address - Fax:410-239-1468
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD99051223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice