Individual
DR. CHARLOTTE MARIE KOOISTRA
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
424 LEONARD ST, JHS 126, BROOKLYN, NY 11222
(718) 782-2527
Mailing address
24-40 27 ST, #3A, ASTORIA, NY 11102-2312
(718) 728-6657
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
038912
NY
Other
Enumeration date
05/02/2007
Last updated
07/08/2007
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