Organization
BOHLE FAMILY DENTISTRY, PSC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES J BOHLE D.M.D. (PRESIDENT)
(270) 442-0256
Entity
Organization
Contact information
Practice address
1836 BROADWAY ST, PADUCAH, KY 42001-2708
(270) 442-0256
(270) 442-8730
Mailing address
1836 BROADWAY ST, PADUCAH, KY 42001-2708
(270) 442-0256
(270) 442-8730
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60056371
—
KY
Enumeration date
05/24/2010
Last updated
05/24/2010
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