| Bohle Family Dentistry, Psc | |
|
1836 Broadway St Paducah KY 42001-2708 | |
| (270) 442-0256 | |
| (270) 442-8730 |
| Full Name | Bohle Family Dentistry, Psc |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 1836 Broadway St, Paducah, Kentucky |
| Authorized Official Name and Position | Charles J Bohle (PRESIDENT) |
| Authorized Official Contact | 2704420256 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bohle Family Dentistry, Psc 1836 Broadway St Paducah KY 42001-2708 Ph: (270) 442-0256 | Bohle Family Dentistry, Psc 1836 Broadway St Paducah KY 42001-2708 Ph: (270) 442-0256 |
| NPI Number | 1003135534 |
|---|---|
| Provider Enumeration Date | 05/24/2010 |
| Last Update Date | 05/24/2010 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003135534 | NPI | - | NPPES |
| 60056371 | Medicaid | KY |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QD0000X | Clinic/center - Dental | (* (Not Available)) | Primary |
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