Provider Demographics
NPI:1467585927
Name:KAHLICH, KERWIN JOHN (DDS)
Entity Type:Individual
Prefix:DR
First Name:KERWIN
Middle Name:JOHN
Last Name:KAHLICH
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 1:114 W REUSS BLVD
Mailing Address - Street 2:
Mailing Address - City:CUERO
Mailing Address - State:TX
Mailing Address - Zip Code:77954-3510
Mailing Address - Country:US
Mailing Address - Phone:361-275-5785
Mailing Address - Fax:361-275-5786
Practice Address - Street 1:114 W REUSS BLVD
Practice Address - Street 2:
Practice Address - City:CUERO
Practice Address - State:TX
Practice Address - Zip Code:77954-3510
Practice Address - Country:US
Practice Address - Phone:361-275-5785
Practice Address - Fax:361-275-5786
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX110181223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice