Individual
DR. CHARLES WILLIAM KOHOUT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
6636 MAIN ST, SUITE5, WILLIAMSVILLE, NY 14221-5967
(716) 633-4747
(716) 633-0328
Mailing address
6636 MAIN ST, SUITE5, WILLIAMSVILLE, NY 14221-5967
(716) 633-4747
(716) 633-0328
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
034924
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
01992378
—
NY
Enumeration date
11/09/2006
Last updated
07/08/2007
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