MEDICARE: KAI STEELE DENTISTRY PLLC

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	2901020556	MI

General Provider Information

NPI Number	:	1508241860
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	KAI STEELE DENTISTRY PLLC

Provider Business Mailing Address
First Line	:	11282 M 140
Second Line	:
City	:	SOUTH HAVEN
State	:	MI
Zip	:	49090-9405
Country	:	US
Telephone Number	:	269-637-8611
Fax Number	:

Provider Business Practice Location Address
First Line	:	11282 M 140
Second Line	:
City	:	SOUTH HAVEN
State	:	MI
Zip	:	49090-9405
Country	:	US
Telephone Number	:	269-637-8611
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. KAI STEELE
Credential	:	DDS
Telephone Number	:	269-637-8611

Provider Enumeration Date	:	07/28/2015
Last Update Date	:	07/28/2015

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