Provider Demographics
NPI:1942219738
Name:KALNIZ DENTAL - ELMHURST
Entity Type:Organization
Organization Name:KALNIZ DENTAL - ELMHURST
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SCOTT
Authorized Official - Middle Name:B
Authorized Official - Last Name:KALNIZ
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:419-536-7265
Mailing Address - Street 1:4014 ELMHURST RD
Mailing Address - Street 2:
Mailing Address - City:TOLEDO
Mailing Address - State:OH
Mailing Address - Zip Code:43613-3724
Mailing Address - Country:US
Mailing Address - Phone:419-536-7265
Mailing Address - Fax:419-536-7760
Practice Address - Street 1:4014 ELMHURST RD
Practice Address - Street 2:
Practice Address - City:TOLEDO
Practice Address - State:OH
Practice Address - Zip Code:43613-3724
Practice Address - Country:US
Practice Address - Phone:419-536-7265
Practice Address - Fax:419-536-7760
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-08-08
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty