Klockow PC
NPI #1861861254 in Rensselaer, Indiana
Provider Information
- NPI Number
- 1861861254
- Entity Type
- Organization
- Organization Name
- Klockow PC
- Primary Specialty
- Clinic/Center - Dental
- Enumeration Date
- Sep 16, 2015
- Last Updated
- Sep 16, 2015
Practice Location
- Address
- 118 S VAN RENSSELAER ST
- City
- Rensselaer
- State
- Indiana
- ZIP Code
- 47978-2815
- Phone
- (219) 869-1097
Authorized Official
- Name
- DR. RAYMOND GORDON KLOCKOW, DDS
- Title
- PRESIDENT
- Phone
- (219) 869-1097
Specialties & Taxonomy Codes
| Specialty |
|---|
| Clinic/Center - Dental — Dental |
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