Provider Demographics
NPI:1659502565
Name:DAHLEN, KATHRYN FILLION (DMD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:FILLION
Last Name:DAHLEN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:342 WALLER AVE APT 8B
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:KY
Mailing Address - Zip Code:40504-2908
Mailing Address - Country:US
Mailing Address - Phone:859-230-6598
Mailing Address - Fax:
Practice Address - Street 1:2401 REGENCY RD STE 202
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40503-2914
Practice Address - Country:US
Practice Address - Phone:859-276-5496
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-07-28
Last Update Date:2009-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY87631223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice