Individual
DR. JACK KAHAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
184 S 1ST ST, FULTON, NY 13069-1720
(315) 593-2506
(315) 593-1896
Mailing address
6070 SINGLETREE LN, JAMESVILLE, NY 13078-9588
(315) 492-2758
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
031457
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00492062
—
NY
Enumeration date
03/25/2006
Last updated
07/08/2007
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