Individual
DR. KELLY K KOEHNEN
Active
Sole proprietor
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
1406 W LAKE ST, STE 100, MINNEAPOLIS, MN 55408-2653
(612) 827-3736
(612) 821-9626
Mailing address
1406 W LAKE ST, STE 100, MINNEAPOLIS, MN 55408-2653
(612) 827-3736
(612) 821-9626
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
10985
MN
Other
Enumeration date
06/20/2005
Last updated
07/08/2007
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