Individual
DR. MATTHEW L KOOYMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1500 W CAYUSE CREEK DR STE 100, MERIDIAN, ID 83646-4757
(508) 884-8858
(208) 884-8915
Mailing address
1500 W CAYUSE CREEK DR STE 100, MERIDIAN, ID 83646-4757
(208) 884-8858
(208) 884-8915
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
D-3565
IL
1223G0001X
General Practice Dentistry
Primary
D-3565
ID
Other
Enumeration date
08/01/2006
Last updated
11/09/2015
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