MEDICARE: MR. KENNETH S LAHR DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223D0001X	Public Health Dentistry	6873	CO

General Provider Information

NPI Number	:	1326046137
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. KENNETH S LAHR DDS

Provider Business Mailing Address
First Line	:	19423 N TURKEY CREEK RD
Second Line	:
City	:	MORRISON
State	:	CO
Zip	:	80465-8902
Country	:	US
Telephone Number	:	303-697-4038
Fax Number	:	303-697-4409

Provider Business Practice Location Address
First Line	:	19423 N TURKEY CREEK RD
Second Line	:
City	:	MORRISON
State	:	CO
Zip	:	80465-8902
Country	:	US
Telephone Number	:	303-697-4038
Fax Number	:	303-697-4409

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/14/2005
Last Update Date	:	07/08/2007

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