Provider Demographics
NPI:1346291804
Name:AHLER, JOHN PATRICK (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:PATRICK
Last Name:AHLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:331 E AMSLER RD
Mailing Address - Street 2:
Mailing Address - City:RENSSELAER
Mailing Address - State:IN
Mailing Address - Zip Code:47978-8591
Mailing Address - Country:US
Mailing Address - Phone:219-866-7117
Mailing Address - Fax:219-866-8658
Practice Address - Street 1:331 E AMSLER RD
Practice Address - Street 2:
Practice Address - City:RENSSELAER
Practice Address - State:IN
Practice Address - Zip Code:47978-8591
Practice Address - Country:US
Practice Address - Phone:219-866-7117
Practice Address - Fax:219-866-8658
Is Sole Proprietor?:No
Enumeration Date:2006-05-12
Last Update Date:2011-10-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN9944122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN200201620AMedicaid
IN200201620AMedicaid