| Douglas J Kosek Dds Pc | |
|
413 West Jefferson Blvd South Bend IN 46601-1514 | |
| (574) 232-2992 | |
| (574) 232-2739 |
| Full Name | Douglas J Kosek Dds Pc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 413 West Jefferson Blvd, South Bend, Indiana |
| Authorized Official Name and Position | Douglas John Kosek (PRESIDENT) |
| Authorized Official Contact | 5742322992 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Douglas J Kosek Dds Pc 413 West Jefferson Blvd South Bend IN 46601-1514 Ph: (574) 232-2992 | Douglas J Kosek Dds Pc 413 West Jefferson Blvd South Bend IN 46601-1514 Ph: (574) 232-2992 |
| NPI Number | 1811064215 |
|---|---|
| Provider Enumeration Date | 11/29/2006 |
| Last Update Date | 08/22/2020 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1811064215 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 12009873 (Indiana) | Primary |
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