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General NPI Number Information
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NPI Number | 1659615466
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Entity Type | Individual
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Provider Name | MR. DAN KAHILL
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Gender | Male
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Dates
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Enumeration Date | 11/16/2012
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Last Update Date | 11/16/2012
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Provider Practice Location Address
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Address Line | 19123 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4008
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Country | US
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Telephone | 313-362-2222
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Fax |
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Provider Business Mailing Address
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Address Line | 19123 W MCNICHOLS RD
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City | DETROIT
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State | MI
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Zip | 48219-4008
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Country | US
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Telephone | 313-362-2222
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Fax | 313-362-2223
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 14805
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License Number State | MI
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Taxonomy #2
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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