Provider Demographics
NPI:1568682938
Name:KAECHELE, DENNIS RICHARD (DDS,MS)
Entity type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:RICHARD
Last Name:KAECHELE
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2031 SUFFOLK ST
Mailing Address - Street 2:
Mailing Address - City:ANN ARBOR
Mailing Address - State:MI
Mailing Address - Zip Code:48103-5049
Mailing Address - Country:US
Mailing Address - Phone:517-456-9972
Mailing Address - Fax:517-456-9973
Practice Address - Street 1:1671 WEST US HWY 12
Practice Address - Street 2:SUITE B
Practice Address - City:CLINTON
Practice Address - State:MI
Practice Address - Zip Code:49236
Practice Address - Country:US
Practice Address - Phone:517-456-9972
Practice Address - Fax:517-456-9973
Is Sole Proprietor?:Yes
Enumeration Date:2007-04-26
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI29010176391223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice