Individual
MICHAEL B KOIDIN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S., M.SC.D.
Contact information
Practice address
77 BROAD ST, LYNN, MA 01902-5003
(781) 599-2900
(781) 598-1670
Mailing address
PO BOX 233, SWAMPSCOTT, MA 01907-0333
(781) 599-2900
(781) 598-1670
Taxonomy
Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
12700
MA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0251771
—
MA
Enumeration date
12/08/2005
Last updated
03/25/2016
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