Individual
JACOB SOENEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
508 N BIRCH ST, KALKASKA, MI 49646-8414
(231) 258-5395
Mailing address
9590 FOWLER LN NW, RAPID CITY, MI 49676-9597
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
2901600122
MI
Other
Enumeration date
06/26/2019
Last updated
06/26/2019
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