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Organization
DOUGLAS J KOSEK D.D.S., P.C.
Active
Organization
DOUGLAS J KOSEK D.D.S., P.C.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KELLY N WEBER (OFFICE ADMINISTRATOR)
(574) 232-2992
Entity
Organization
Contact information
Practice address
413 W JEFFERSON BLVD, SOUTH BEND, IN 46601-1514
(574) 232-2992
Mailing address
413 W JEFFERSON BLVD, SOUTH BEND, IN 46601-1514
(574) 232-2992
Taxonomy
Speciality
Code
Description
License number
State
261QD0000X
Dental Clinic/Center
Primary
—
—
Other
Enumeration date
05/02/2018
Last updated
05/02/2018
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