Provider Demographics
NPI:1639218803
Name:KIEHNE, JAMES H (DDS)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:H
Last Name:KIEHNE
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 1:215 E CENTER DR
Mailing Address - Street 2:SUITE E
Mailing Address - City:ALTON
Mailing Address - State:IL
Mailing Address - Zip Code:62002-5993
Mailing Address - Country:US
Mailing Address - Phone:618-462-2858
Mailing Address - Fax:
Practice Address - Street 1:215 E CENTER DR
Practice Address - Street 2:SUITE E
Practice Address - City:ALTON
Practice Address - State:IL
Practice Address - Zip Code:62002-5993
Practice Address - Country:US
Practice Address - Phone:618-462-2858
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-02-05
Last Update Date:2008-01-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist