Provider Demographics
NPI:1366476368
Name:HENRY J KAEHLER JR DDS PC
Entity Type:Organization
Organization Name:HENRY J KAEHLER JR DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KAEHLER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:918-762-2533
Mailing Address - Street 1:401 FOREST ST
Mailing Address - Street 2:
Mailing Address - City:PAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74058
Mailing Address - Country:US
Mailing Address - Phone:918-762-2573
Mailing Address - Fax:918-762-1033
Practice Address - Street 1:401 FOREST ST
Practice Address - Street 2:
Practice Address - City:PAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74058
Practice Address - Country:US
Practice Address - Phone:918-762-2573
Practice Address - Fax:918-762-1033
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-10
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK5607261QM2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM2500XAmbulatory Health Care FacilitiesClinic/CenterMedical Specialty