Provider Demographics
NPI:1538543236
Name:JOSEPH J KOHLER III DDS
Entity type:Organization
Organization Name:JOSEPH J KOHLER III DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DR./OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:JOHN
Authorized Official - Last Name:KOHLER
Authorized Official - Suffix:III
Authorized Official - Credentials:DDS
Authorized Official - Phone:814-452-4838
Mailing Address - Street 1:219 W 7TH ST
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16501-1601
Mailing Address - Country:US
Mailing Address - Phone:814-452-4838
Mailing Address - Fax:814-453-3413
Practice Address - Street 1:219 W 7TH ST
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16501-1601
Practice Address - Country:US
Practice Address - Phone:814-452-4838
Practice Address - Fax:814-453-3413
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-07-13
Last Update Date:2015-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PADS023124L1223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty