Provider Demographics
NPI:1861555161
Name:RICHARD M. KAHN D.D.S., P.A.
Entity type:Organization
Organization Name:RICHARD M. KAHN D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:MICHAEL
Authorized Official - Last Name:KAHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:609-877-1650
Mailing Address - Street 1:2 MAINBRIDGE LN
Mailing Address - Street 2:
Mailing Address - City:WILLINGBORO
Mailing Address - State:NJ
Mailing Address - Zip Code:08046-2104
Mailing Address - Country:US
Mailing Address - Phone:609-877-1650
Mailing Address - Fax:609-877-2178
Practice Address - Street 1:2 MAINBRIDGE LN
Practice Address - Street 2:
Practice Address - City:WILLINGBORO
Practice Address - State:NJ
Practice Address - Zip Code:08046-2104
Practice Address - Country:US
Practice Address - Phone:609-877-1650
Practice Address - Fax:609-877-2178
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ76311223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Single Specialty