Healthcare Provider Details

I. General information

NPI: 1295843944
Provider Name (Legal Business Name): GENE PAUL KAHN DMD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/25/2006
Last Update Date: 10/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

CMR 402 LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
APO AE
09180
US

IV. Provider business mailing address

CMR 402 LANDSTUHL DENTAL ACTIVITY CREDENTIALS OFFICE
APO AE
09180
US

V. Phone/Fax

Practice location:
  • Phone: 496371929130
  • Fax: 496371929191
Mailing address:
  • Phone: 496371929130
  • Fax: 496371929191

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number51730
License Number StateCA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: