| Kevin Lloyd Kohler Dmd Inc | |
|
13512 Poway Rd Poway CA 92064-4716 | |
| (858) 486-4775 | |
| Not Available |
| Full Name | Kevin Lloyd Kohler Dmd Inc |
|---|---|
| Speciality | Dentist |
| Location | 13512 Poway Rd, Poway, California |
| Authorized Official Name and Position | Kevin Kohler (OWNER) |
| Authorized Official Contact | 8584864775 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Kevin Lloyd Kohler Dmd Inc 13512 Poway Rd Poway CA 92064-4716 Ph: () - | Kevin Lloyd Kohler Dmd Inc 13512 Poway Rd Poway CA 92064-4716 Ph: (858) 486-4775 |
| NPI Number | 1801419338 |
|---|---|
| Provider Enumeration Date | 05/19/2020 |
| Last Update Date | 05/19/2020 |
| Medicare PECOS PAC ID | 6800217142 |
|---|---|
| Medicare Enrollment ID | O20200522000736 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1801419338 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223S0112X | Dentist - Oral And Maxillofacial Surgery | (* (Not Available)) | Primary |
| Provider Name | Kevin Lloyd Kohler |
|---|---|
| Provider Type | Practitioner - Oral Surgery |
| Provider Identifiers | NPI Number: 1790797371 PECOS PAC ID: 7618398959 Enrollment ID: I20200522000774 |
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