| Koentjoro & Le Dentistry Plc | |
|
3617 Denmark Dr Ste 100 Council Bluffs IA 51501-7756 | |
| (712) 326-3205 | |
| Not Available |
| Full Name | Koentjoro & Le Dentistry Plc |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 3617 Denmark Dr Ste 100, Council Bluffs, Iowa |
| Authorized Official Name and Position | Aldo Koentjoro (OWNER) |
| Authorized Official Contact | 7123263205 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Koentjoro & Le Dentistry Plc Po Box 3189 Syracuse NY 13220-3189 Ph: () - | Koentjoro & Le Dentistry Plc 3617 Denmark Dr Ste 100 Council Bluffs IA 51501-7756 Ph: (712) 326-3205 |
| NPI Number | 1104494830 |
|---|---|
| Provider Enumeration Date | 06/17/2021 |
| Last Update Date | 06/24/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1104494830 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | (* (Not Available)) | Primary |
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