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Organization

DOUGLAS W. KOENKE, D.D.S.

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DOUGLAS WILLIAM KOENKE D.D.S. (OWNER)
(586) 566-0088
Entity
Organization

Contact information

Practice address
42850 SCHOENHERR RD, SUITE 5, STERLING HEIGHTS, MI 48313-2875
(586) 566-0088
(586) 566-0568
Mailing address
42850 SCHOENHERR RD, SUITE 5, STERLING HEIGHTS, MI 48313-2875
(586) 566-0088
(586) 566-0568

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
13000
MI

Other

Enumeration date
04/25/2007
Last updated
10/24/2007
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