Individual
DR. KYLE JOSEPH FONKEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
415 E COOLBAUGH ST, RED OAK, IA 51566-2319
(712) 623-3383
Mailing address
105 S 38TH ST APT 203, COUNCIL BLUFFS, IA 51501-3385
(208) 921-6211
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
DDS-09556
IA
Other
Enumeration date
06/25/2018
Last updated
06/25/2018
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