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NPI Code Detail

MEDICARE: JAMES D KOHLER DDS PC

MEDICARE: JAMES D KOHLER DDS PC
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
1122300000XDentist11827MI

General Provider Information

NPI Number : 1386814077
Entity Type Code : Organization
Provider Name (Legal Business Name) : JAMES D KOHLER DDS PC
Provider Business Mailing Address
First Line : 20411 W 12 MILE
Second Line : SUITE 102
City : SOUTHFIELD
State : MI
Zip : 48076-6404
Country : US
Telephone Number : 248-352-1110
Fax Number : 248-352-0801
Provider Business Practice Location Address
First Line : 20411 W 12 MILE
Second Line : SUITE 102
City : SOUTHFIELD
State : MI
Zip : 48076-6404
Country : US
Telephone Number : 248-352-1110
Fax Number : 248-352-0801
Authorized Official
Title or Position : OWNER
Name : DR. JAMES D KOHLER
Credential : DDS
Telephone Number : 248-352-1110
Provider Enumeration Date : 03/10/2008
Last Update Date : 03/10/2008

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