| Mark E. Koonmen, Dds, Ms, Pc | |
|
1122 S Linden Rd Flint MI 48532-3437 | |
| (810) 732-0640 | |
| (810) 732-2264 |
| Full Name | Mark E. Koonmen, Dds, Ms, Pc |
|---|---|
| Speciality | Dentist - Pediatric Dentistry |
| Location | 1122 S Linden Rd, Flint, Michigan |
| Authorized Official Name and Position | Mark Edward Koonmen (OWNER/PRESIDENT) |
| Authorized Official Contact | 8107320640 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark E. Koonmen, Dds, Ms, Pc 1122 S Linden Rd Flint MI 48532-3437 Ph: (810) 732-0640 | Mark E. Koonmen, Dds, Ms, Pc 1122 S Linden Rd Flint MI 48532-3437 Ph: (810) 732-0640 |
| NPI Number | 1396825998 |
|---|---|
| Provider Enumeration Date | 10/17/2006 |
| Last Update Date | 03/24/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1396825998 | NPI | - | NPPES |
| 1831730 | Medicaid | MI |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223P0221X | Dentist - Pediatric Dentistry | 13770 (Michigan) | Primary |
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