Organization
BOB KOENITZER DDS, INC.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
BOB DAVID KOENITZER DDS (OWNER)
(707) 766-6666
Entity
Organization
Contact information
Practice address
101 LYNCH CREEK WAY, PETALUMA, CA 94954-8301
(707) 766-6666
(707) 763-1614
Mailing address
101 LYNCH CREEK WAY, PETALUMA, CA 94954-8301
(707) 766-6666
(707) 763-1614
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
34624
CA
Other
Enumeration date
02/07/2008
Last updated
02/07/2008
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