Individual
DOUGLAS JOHN KOSEK
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
413 W JEFFERSON BLVD, SOUTH BEND, IN 46601-1514
(574) 232-2992
(574) 232-2739
Mailing address
533 N COQUILLARD DR, SOUTH BEND, IN 46617-2554
(574) 288-3308
(574) 232-2739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009873
IN
Other
Enumeration date
03/29/2007
Last updated
07/08/2007
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