Provider Demographics
NPI:1841346145
Name:KOHLER, MICHELLE RAE (DDS)
Entity type:Individual
Prefix:DR
First Name:MICHELLE
Middle Name:RAE
Last Name:KOHLER
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 1:20892 E PARLIAMENT PL
Mailing Address - Street 2:
Mailing Address - City:PARKER
Mailing Address - State:CO
Mailing Address - Zip Code:80138-7322
Mailing Address - Country:US
Mailing Address - Phone:574-514-4861
Mailing Address - Fax:
Practice Address - Street 1:1062 AKRON WAY
Practice Address - Street 2:BLDG. 753
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80230-7102
Practice Address - Country:US
Practice Address - Phone:574-514-4861
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-27
Last Update Date:2013-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN12010875A1223G0001X
CO9567122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223G0001XDental ProvidersDentistGeneral Practice