Provider Demographics
NPI:1922143585
Name:JOHN C. KALL, D.M.D.
Entity Type:Organization
Organization Name:JOHN C. KALL, D.M.D.
Other - Org Name:DENTAL HEALTH CENTER
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:LISA
Authorized Official - Middle Name:A
Authorized Official - Last Name:YANKOWY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:502-423-0781
Mailing Address - Street 1:2323 LIME KILN LN
Mailing Address - Street 2:
Mailing Address - City:LOUISVILLE
Mailing Address - State:KY
Mailing Address - Zip Code:40222-3416
Mailing Address - Country:US
Mailing Address - Phone:502-423-0781
Mailing Address - Fax:
Practice Address - Street 1:2323 LIME KILN LN
Practice Address - Street 2:
Practice Address - City:LOUISVILLE
Practice Address - State:KY
Practice Address - Zip Code:40222-3416
Practice Address - Country:US
Practice Address - Phone:502-423-0781
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-02-21
Last Update Date:2008-06-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY4715122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty