Provider Demographics
NPI:1477710606
Name:KUEHN, WILTON HENRY JR (DMD)
Entity Type:Individual
Prefix:DR
First Name:WILTON
Middle Name:HENRY
Last Name:KUEHN
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 576
Mailing Address - Street 2:
Mailing Address - City:TURTLE LAKE
Mailing Address - State:ND
Mailing Address - Zip Code:58575-0576
Mailing Address - Country:US
Mailing Address - Phone:701-448-9111
Mailing Address - Fax:
Practice Address - Street 1:416 KUNDERT ST
Practice Address - Street 2:
Practice Address - City:TURTLE LAKE
Practice Address - State:ND
Practice Address - Zip Code:58575-0576
Practice Address - Country:US
Practice Address - Phone:701-448-9111
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-05-16
Last Update Date:2008-05-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NDND1592122300000X
AZD2647122300000X
ORD5778122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist