MEDICARE: W.M. KAIS, DDS PLC

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	261QD0000X	Dental Clinic/Center

General Provider Information

NPI Number	:	1366049009
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	W.M. KAIS, DDS PLC

Provider Business Mailing Address
First Line	:	1411 CENTER AVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-6109
Country	:	US
Telephone Number	:	989-892-7062
Fax Number	:

Provider Business Practice Location Address
First Line	:	1411 CENTER AVE
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-6109
Country	:	US
Telephone Number	:	989-892-7062
Fax Number	:

Authorized Official
Title or Position	:	SELF
Name	:	WALEED KAIS
Credential	:
Telephone Number	:	989-892-7062

Provider Enumeration Date	:	10/06/2020
Last Update Date	:	10/06/2020

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