Provider Demographics
NPI:1861805061
Name:KLATT, V JUNIA (RDH)
Entity type:Individual
Prefix:
First Name:V JUNIA
Middle Name:
Last Name:KLATT
Suffix:
Gender:F
Credentials:RDH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 961
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:CO
Mailing Address - Zip Code:80026-0961
Mailing Address - Country:US
Mailing Address - Phone:720-318-3839
Mailing Address - Fax:
Practice Address - Street 1:877 E SOUTH BOULDER RD
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:CO
Practice Address - Zip Code:80027-1345
Practice Address - Country:US
Practice Address - Phone:303-665-8228
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2014-06-05
Last Update Date:2014-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO2023431124Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes124Q00000XDental ProvidersDental Hygienist