Healthcare Provider Details

I. General information

NPI: 1326046137
Provider Name (Legal Business Name): KENNETH S LAHR DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 07/14/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

19423 N TURKEY CREEK RD
MORRISON CO
80465-8902
US

IV. Provider business mailing address

19423 N TURKEY CREEK RD
MORRISON CO
80465-8902
US

V. Phone/Fax

Practice location:
  • Phone: 303-697-4038
  • Fax: 303-697-4409
Mailing address:
  • Phone: 303-697-4038
  • Fax: 303-697-4409

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223D0001X
TaxonomyPublic Health Dentistry
License Number6873
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: