Organization
HUCKMAN DENTAL PROFESSIONALS, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY MARIE KOENEG D.D.S. (MANAGING MEMBER)
(361) 243-6242
Entity
Organization
Contact information
Practice address
106 E CORPUS CHRISTI ST, SUITE C, BEEVILLE, TX 78102-5600
(361) 358-5151
(361) 358-5524
Mailing address
106 E CORPUS CHRISTI ST, SUITE C, BEEVILLE, TX 78102-5600
(361) 358-5151
(361) 358-5524
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
22869
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2146748-02
—
TX
Enumeration date
01/18/2012
Last updated
01/18/2012
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