Provider Demographics
NPI:1457083586
Name:BOHN, RACHEL (DDS)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:
Last Name:BOHN
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11511 W GODSELL AVE
Mailing Address - Street 2:
Mailing Address - City:HALES CORNERS
Mailing Address - State:WI
Mailing Address - Zip Code:53130-1821
Mailing Address - Country:US
Mailing Address - Phone:262-707-7854
Mailing Address - Fax:
Practice Address - Street 1:7400 W RAWSON AVE STE 233
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:WI
Practice Address - Zip Code:53132-8280
Practice Address - Country:US
Practice Address - Phone:414-525-0300
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-28
Last Update Date:2022-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI600003815122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist