Provider Demographics
NPI:1104356310
Name:KOHLER, JAMIE KATHERINE KERN (DDS)
Entity Type:Individual
Prefix:DR
First Name:JAMIE
Middle Name:KATHERINE KERN
Last Name:KOHLER
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:DR
Other - First Name:JAMIE
Other - Middle Name:KATHERINE
Other - Last Name:KERN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:DDS
Mailing Address - Street 1:112 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:HOWARD
Mailing Address - State:SD
Mailing Address - Zip Code:57349-9055
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:112 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:SD
Practice Address - Zip Code:57349-9055
Practice Address - Country:US
Practice Address - Phone:612-791-7161
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-20
Last Update Date:2017-06-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SDD11551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice