Provider Demographics
NPI:1316308117
Name:KACHELE, WILLIAM S JR (DMD)
Entity type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:S
Last Name:KACHELE
Suffix:JR
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:751 RANCHEROS DR
Mailing Address - Street 2:SUITE 3
Mailing Address - City:SAN MARCOS
Mailing Address - State:CA
Mailing Address - Zip Code:92069-3041
Mailing Address - Country:US
Mailing Address - Phone:760-471-7115
Mailing Address - Fax:
Practice Address - Street 1:751 RANCHEROS DR
Practice Address - Street 2:SUITE 3
Practice Address - City:SAN MARCOS
Practice Address - State:CA
Practice Address - Zip Code:92069-3041
Practice Address - Country:US
Practice Address - Phone:760-471-7115
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-03-08
Last Update Date:2016-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA034858122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist