Individual
DR. JEREMY PARCO KOONTZ
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DMD
Contact information
Practice address
2617 GRIFFIN AVE, ENUMCLAW, WA 98022-2380
(360) 825-2191
Mailing address
2617 GRIFFIN AVE, ENUMCLAW, WA 98022-2380
(360) 825-2191
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DE61100694
WA
Other
Enumeration date
10/06/2020
Last updated
10/06/2020
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