Dr Brian D Klockow, DDS is a
Dentist based in Wabeno, Wisconsin. Dr Brian D Klockow is licensed to practice in Wisconsin (license number 2274) and his current practice location is
4488 N Branch St, Wabeno, Wisconsin. He can be reached at his office (for appointments etc.) via phone at
(715) 473-6711.
NPI number for Dr Brian D Klockow is 1881605921 and his current mailing address is Po Box 161, Wabeno, Wisconsin. He
does not participate in medicare program and thus does not accept medicare assignments. His NPI Number is 1881605921.
Healthcare Provider's Profile
| Full Name | Dr Brian D Klockow |
|---|
| Gender | Male |
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| Speciality | Dentist |
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| Location | 4488 N Branch St, Wabeno, Wisconsin |
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| Accepts Medicare Assignments | Does not participate in Medicare Program. He may not accept medicare assignment. |
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NPI Data:
- NPI Number: 1881605921
- Provider Enumeration Date: 08/11/2006
- Last Update Date: 07/08/2007
Medical Identifiers
Medical identifiers for Dr Brian D Klockow such as npi, medicare ID, medicare PIN, medicaid, etc.
| Identifier | Type | State | Issuer |
|---|
| 1881605921 | NPI | - | NPPES |
Medical Taxonomies and Licenses
| Taxonomy | Type | License (State) | Status |
|---|
| 122300000X | Dentist | 2274 (Wisconsin) | Primary |
Medicare Part D Prescriber Enrollment
Any physician or other eligible professional who prescribes Part D drugs must either enroll in the Medicare program or opt out in order to prescribe drugs to their patients with Part D prescription drug benefit plans. Dr Brian D Klockow is
NOT enrolled with medicare and thus cannot prescribe medicare part D drugs to patients with medicare part D benefits.
Mailing Address and Practice Location
| Mailing Address | Practice Location Address |
|---|
Dr Brian D Klockow, DDS
Po Box 161,
Wabeno, WI 54566-0161
Ph: (715) 473-6711 | Dr Brian D Klockow, DDS
4488 N Branch St,
Wabeno, WI 54566-0161
Ph: (715) 473-6711 |
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