Provider Demographics
NPI:1871729079
Name:KLEMENT, KRISTEN E (DMD)
Entity type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:E
Last Name:KLEMENT
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7650 38TH AVE N
Mailing Address - Street 2:
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-1233
Mailing Address - Country:US
Mailing Address - Phone:727-343-8831
Mailing Address - Fax:727-345-5396
Practice Address - Street 1:7650 38TH AVE N
Practice Address - Street 2:
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-1233
Practice Address - Country:US
Practice Address - Phone:727-343-8831
Practice Address - Fax:727-345-5396
Is Sole Proprietor?:No
Enumeration Date:2009-06-03
Last Update Date:2009-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN18648122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist