Healthcare Provider Details

I. General information

NPI: 1104043157
Provider Name (Legal Business Name): MICHAEL JEFFREY KUHN D.D.S.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

23415 THREE NOTCH RD SUITE #2003
CALIFORNIA MD
20619-4017
US

IV. Provider business mailing address

1938 MOUNTAIN AVE
BALTIMORE MD
21234-2726
US

V. Phone/Fax

Practice location:
  • Phone: 301-862-4424
  • Fax:
Mailing address:
  • Phone: 410-882-4743
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223X0400X
TaxonomyOrthodontics and Dentofacial Orthopedics Dentistry
License Number9902
License Number StateMD

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: