Provider Demographics
NPI:1144461401
Name:LINDA M. KLATT
Entity type:Organization
Organization Name:LINDA M. KLATT
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:LINDA
Authorized Official - Middle Name:MARIE
Authorized Official - Last Name:KLATT
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:814-355-7731
Mailing Address - Street 1:140 W BISHOP ST
Mailing Address - Street 2:
Mailing Address - City:BELLEFONTE
Mailing Address - State:PA
Mailing Address - Zip Code:16823-1927
Mailing Address - Country:US
Mailing Address - Phone:814-355-7731
Mailing Address - Fax:814-355-0213
Practice Address - Street 1:140 W BISHOP ST
Practice Address - Street 2:
Practice Address - City:BELLEFONTE
Practice Address - State:PA
Practice Address - Zip Code:16823-1927
Practice Address - Country:US
Practice Address - Phone:814-355-7731
Practice Address - Fax:814-355-0213
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-17
Last Update Date:2009-03-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS021928L1223G0001X
PADH004808L124Q00000X
PADH009277L124Q00000X
PADH006857L124Q00000X
PADS0355811223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
No124Q00000XDental ProvidersDental HygienistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1295980459OtherNPI TYPE I
1790841708OtherNPI TYPE I