Provider Demographics
NPI:1487829487
Name:KOBERLEIN, JOSEPH A (DDS)
Entity Type:Individual
Prefix:DR
First Name:JOSEPH
Middle Name:A
Last Name:KOBERLEIN
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 1:3869 DARROW RD
Mailing Address - Street 2:SUITE 201
Mailing Address - City:STOW
Mailing Address - State:OH
Mailing Address - Zip Code:44224-2691
Mailing Address - Country:US
Mailing Address - Phone:330-688-9922
Mailing Address - Fax:
Practice Address - Street 1:3869 DARROW RD
Practice Address - Street 2:SUITE 201
Practice Address - City:STOW
Practice Address - State:OH
Practice Address - Zip Code:44224-2691
Practice Address - Country:US
Practice Address - Phone:330-688-9922
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-04-30
Last Update Date:2008-04-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH182411223P0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0300XDental ProvidersDentistPeriodontics