Provider Demographics
NPI:1851595896
Name:TIMOTHY E KAHN DDS PC
Entity Type:Organization
Organization Name:TIMOTHY E KAHN DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:TIMOTHY
Authorized Official - Middle Name:EDWARD
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:970-641-1177
Mailing Address - Street 1:545 COUNTY ROAD 48 E
Mailing Address - Street 2:
Mailing Address - City:GUNNISON
Mailing Address - State:CO
Mailing Address - Zip Code:81230-2515
Mailing Address - Country:US
Mailing Address - Phone:970-641-1177
Mailing Address - Fax:
Practice Address - Street 1:545 COUNTY ROAD 48 E
Practice Address - Street 2:
Practice Address - City:GUNNISON
Practice Address - State:CO
Practice Address - Zip Code:81230-2515
Practice Address - Country:US
Practice Address - Phone:970-641-1177
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-13
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO7690122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty