Provider Demographics
NPI:1639654734
Name:KIRCHER FAMILY DENTISTRY
Entity Type:Organization
Organization Name:KIRCHER FAMILY DENTISTRY
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:EDWARD
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:KIRCHER
Authorized Official - Suffix:JR
Authorized Official - Credentials:DDS
Authorized Official - Phone:319-524-1431
Mailing Address - Street 1:1610 MORGAN ST STE 4
Mailing Address - Street 2:
Mailing Address - City:KEOKUK
Mailing Address - State:IA
Mailing Address - Zip Code:52632-3423
Mailing Address - Country:US
Mailing Address - Phone:319-524-1431
Mailing Address - Fax:319-524-5905
Practice Address - Street 1:1610 MORGAN ST STE 4
Practice Address - Street 2:
Practice Address - City:KEOKUK
Practice Address - State:IA
Practice Address - Zip Code:52632-3423
Practice Address - Country:US
Practice Address - Phone:319-524-1431
Practice Address - Fax:319-524-5905
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental