Individual
DR. BEN MICHAEL KOOLICK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8390 W CACTUS RD STE 110, PEORIA, AZ 85381-5206
(623) 878-3300
Mailing address
9494 E DESERT COVE AVE, SCOTTSDALE, AZ 85260-6144
(480) 767-1338
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
AZ6037
AZ
Other
Enumeration date
08/22/2005
Last updated
04/03/2011
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