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General NPI Number Information
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NPI Number | 1356577498
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Entity Type | Organization
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Legal Business Name | DARNELL KAIGLER D D S P C
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Dates
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Enumeration Date | 06/03/2009
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Last Update Date | 12/27/2010
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Provider Practice Location Address
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Address Line | 2671 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48208-1203
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Country | US
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Telephone | 313-871-0436
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Fax | 313-871-4807
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Provider Business Mailing Address
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Address Line | 2671 W GRAND BLVD
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City | DETROIT
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State | MI
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Zip | 48208
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Country | US
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Telephone | 313-871-0436
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Fax | 313-871-4807
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Authorized Official
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Title or Position | PERIODONTIST
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Name | DR. DARNELL KAIGLER JR.
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Credential | D.D.S,M.S.,PH.D
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Telephone | 313-871-0436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223P0300X
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Taxonomy Name | Periodontics
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License Number | 2901018534
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License Number State | MI
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