Koonmen, Mark Edward
Koonmen, Mark Edward is an individual health care provider with primary practice located at 1122 S Linden Rd , Flint MI 48532-3437. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Koonmen, Mark Edward can be contacted via phone (810) 732-0640.Contact Information
Primary practice address
1122 S Linden Rd
Flint MI 48532-3437
Phone: (810) 732-0640
Fax: (810) 732-2264
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Dental Providers / Pediatric Dentistry | 1223P0221X | 13770 | Michigan |
Profile Details
| NPI number | 1326028044 |
|---|---|
| LBN Legal business name | Koonmen, Mark Edward |
| Credentials | Doctor of Dental Surgery (DDS) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Jul 8th, 2007 - about 18 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326028044 | NPPES |
| Michigan | Other | J801645 | BLUE CROSS AND BLUE SHIEL |
| Michigan | MEDICAID | 1831730 | BLUE CROSS AND BLUE SHIEL |
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