Provider Demographics
NPI:1790797371
Name:KOHLER, KEVIN LLOYD (DMD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LLOYD
Last Name:KOHLER
Suffix:
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 1:13512 POWAY RD
Mailing Address - Street 2:
Mailing Address - City:POWAY
Mailing Address - State:CA
Mailing Address - Zip Code:92064-4716
Mailing Address - Country:US
Mailing Address - Phone:858-486-4775
Mailing Address - Fax:
Practice Address - Street 1:13512 POWAY RD
Practice Address - Street 2:
Practice Address - City:POWAY
Practice Address - State:CA
Practice Address - Zip Code:92064-4716
Practice Address - Country:US
Practice Address - Phone:858-486-4775
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-12
Last Update Date:2014-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA592271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice