# MARVIN C KOONCE DDS PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1396880480
- **Authorized official:** MARVIN C KOONCE DDS (PRESIDENT)
- **Authorized official phone:** (931) 684-2445

## Contact information

- **Practice address:** 603 N MAIN ST, SHELBYVILLE, TN 37160-3210
- **Practice address phone:** (931) 684-2445
- **Practice address fax:** (931) 684-6201
- **Mailing address:** PO BOX 741, SHELBYVILLE, TN 37162-0741
- **Mailing address phone:** (931) 684-2445
- **Mailing address fax:** (931) 684-6201

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 1223G0001X | General Practice Dentistry | DS2322 | TN | Yes |

## Other

- **Enumeration date:** 02/20/2007
- **Last updated:** 08/22/2020