Provider Demographics
NPI:1295715084
Name:KOHLER, JAMES DOUGLAS (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:DOUGLAS
Last Name:KOHLER
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20411 W 12 MILE RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:SOUTHFIELD
Mailing Address - State:MI
Mailing Address - Zip Code:48076-5414
Mailing Address - Country:US
Mailing Address - Phone:248-352-1110
Mailing Address - Fax:
Practice Address - Street 1:20411 W 12 MILE RD
Practice Address - Street 2:SUITE 102
Practice Address - City:SOUTHFIELD
Practice Address - State:MI
Practice Address - Zip Code:48076-5414
Practice Address - Country:US
Practice Address - Phone:248-352-1110
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-01-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI118271223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice