John Robert Kesler, DDS PS

Individual provider Active NPI General Practice Dentistry · Landis, NC

NPI 1295886083 · NPPES record last updated Jul 8, 2007

Key facts

NPI
1295886083
Entity type
Individual (NPI type 1)
Primary specialty
General Practice Dentistry 1223G0001X
License
4078 (NC)
Practice address
1010 South Main Street
Landis, NC 28088
Phone
(704) 857-6151
Fax
(704) 857-6152
NPI assigned
Jan 16, 2007
Sex
Male
Sole proprietor
No

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
4078NCMDSpeech-Language Pathologist

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 4078 NC Yes

Addresses

Primary practice location

1010 South Main Street
Landis, NC 28088

Mailing address

1010 South Main Street
Landis, NC 28088
Phone (704) 857-6151

Other identifiers

IdentifierTypeStateIssuer
8994864MedicaidNC

Other providers in Landis, NC

All providers in Landis, NC · General Practice Dentistry in North Carolina

Sources for this page

Verify at the official NPI Registry.