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Individual

DR. LISA JAYNE KOENIG

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
BCHD, DDS, MS

Contact information

Practice address
MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY, 1801 WEST WISCONSIN AVENUE, MILWAUKEE, WI 53233
(414) 288-5675
(414) 288-6081
Mailing address
MARQUETTE UNIVERSITY SCHOOL OF DENTISTRY, PO BOX 1881, MILWAUKEE, WI 53201-1881
(414) 288-5675
(414) 288-6081

Taxonomy

Speciality
Code
Description
License number
State
1223X0008X
Oral and Maxillofacial Radiology Dentistry
Primary
3846
WI

Other

Enumeration date
10/03/2006
Last updated
07/08/2007
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