Provider Demographics
NPI:1780750166
Name:DRS. FUHST WYLIE AND KAHN, FAMILY DENTAL CARE, PLLC
Entity type:Organization
Organization Name:DRS. FUHST WYLIE AND KAHN, FAMILY DENTAL CARE, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:ANTHONY
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:517-546-3180
Mailing Address - Street 1:416 E GRAND RIVER AVE
Mailing Address - Street 2:
Mailing Address - City:HOWELL
Mailing Address - State:MI
Mailing Address - Zip Code:48843-2325
Mailing Address - Country:US
Mailing Address - Phone:517-546-3180
Mailing Address - Fax:
Practice Address - Street 1:416 E GRAND RIVER AVE
Practice Address - Street 2:
Practice Address - City:HOWELL
Practice Address - State:MI
Practice Address - Zip Code:48843-2325
Practice Address - Country:US
Practice Address - Phone:517-546-3180
Practice Address - Fax:517-546-5824
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-28
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI15823122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty