Individual
DR. MARVIN CLAY KOONCE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
603 N MAIN ST, SHELBYVILLE, TN 37160-3210
(931) 684-2445
Mailing address
P O BOX 741, SHELBYVILLE, TN 37162-0741
(931) 684-2445
(931) 684-6201
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2322
TN
Other
Enumeration date
11/23/2007
Last updated
11/23/2007
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