Provider Demographics
NPI:1477742575
Name:MARC J. KAHN D.M.D.
Entity Type:Organization
Organization Name:MARC J. KAHN D.M.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:JEFFREY
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:781-444-4870
Mailing Address - Street 1:1233 HIGHLAND AVE
Mailing Address - Street 2:
Mailing Address - City:NEEDHAM
Mailing Address - State:MA
Mailing Address - Zip Code:02492-2697
Mailing Address - Country:US
Mailing Address - Phone:781-444-4870
Mailing Address - Fax:781-444-2575
Practice Address - Street 1:1233 HIGHLAND AVE
Practice Address - Street 2:
Practice Address - City:NEEDHAM
Practice Address - State:MA
Practice Address - Zip Code:02492-2697
Practice Address - Country:US
Practice Address - Phone:781-444-4870
Practice Address - Fax:781-444-2575
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-10-15
Last Update Date:2007-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA0148571223S0112X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223S0112XDental ProvidersDentistOral and Maxillofacial SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MAX11053OtherBLUE CROSS BLUE SHIELD