Individual
DR. GREGORY LEONARD KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
200 MERCY CIRCLE, OCEANSIDE, CA 92055
(757) 300-6695
Mailing address
11612 MILBERN DR, POTOMAC, MD 20854-3522
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
Primary
0401411550
VA
1223P0300X
Periodontics
28850
TX
Other
Enumeration date
08/24/2006
Last updated
07/12/2024
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