Provider Demographics
NPI:1366578502
Name:KLINAR, KARL STEPHEN (DMD)
Entity type:Individual
Prefix:
First Name:KARL
Middle Name:STEPHEN
Last Name:KLINAR
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6320 SAINT ANDREWS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29212-3126
Mailing Address - Country:US
Mailing Address - Phone:803-772-5161
Mailing Address - Fax:803-772-4441
Practice Address - Street 1:6320 SAINT ANDREWS RD
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-3126
Practice Address - Country:US
Practice Address - Phone:803-772-5161
Practice Address - Fax:803-772-4441
Is Sole Proprietor?:No
Enumeration Date:2007-02-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC28771223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice