Organization
DOUGLAS J KOSEK DDS PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DOUGLAS JOHN KOSEK DDS (PRESIDENT)
(574) 232-2992
Entity
Organization
Contact information
Practice address
413 WEST JEFFERSON BLVD, SOUTH BEND, IN 46601-1514
(574) 232-2992
(574) 232-2739
Mailing address
413 WEST JEFFERSON BLVD, SOUTH BEND, IN 46601-1514
(574) 232-2992
(574) 232-2739
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12009873
IN
Other
Enumeration date
11/29/2006
Last updated
08/22/2020
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