Individual
KEVIN HENRY IMOEHL
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
11 1ST AVE NE, OELWEIN, IA 50662
(319) 283-4738
(319) 283-4754
Mailing address
11 1ST AVE NE, OELWEIN, IA 50662
(319) 283-4738
(319) 283-4754
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
IA07072
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0039818
—
IA
01
—
24254
BCBS
IA
Enumeration date
06/17/2006
Last updated
07/08/2007
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