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General NPI Number Information
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NPI Number | 1972250249
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Entity Type | Individual
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Provider Name | KEVIN MICHAEL RAHN DMD
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Gender | Male
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Dates
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Enumeration Date | 03/07/2022
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Last Update Date | 01/30/2024
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Provider Practice Location Address
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Address Line | 31 NE STATE ROUTE 300 STE 200
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City | BELFAIR
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State | WA
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Zip | 98528-8668
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Country | US
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Telephone | 360-377-3776
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Fax |
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Provider Business Mailing Address
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Address Line | 3829 WINCHESTER RD
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City | PETERSBURG
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State | PA
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Zip | 16669-2820
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Country | US
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Telephone | 814-571-7147
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Fax |
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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 | DE61397387
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License Number State | WA
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