Kootman, Jeffrey Howard

Kootman, Jeffrey Howard is an individual health care provider with primary practice located at 702 E Bell Rd B103, Phoenix AZ 85022. He recently has only one registered license in Dental Providers / Oral and Maxillofacial Surgery, which is considered as his primary health care specialty. Kootman, Jeffrey Howard can be contacted via phone (602) 493-1140.

Contact Information

Primary practice address
702 E Bell Rd B103 Phoenix AZ 85022
Phone: (602) 493-1140
Fax: (602) 493-5328
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Oral and Maxillofacial Surgery 1223S0112X 3369 Arizona

Profile Details

NPI number 1205991858
LBN Legal business name Kootman, Jeffrey Howard
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 26th, 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1205991858 NPPES
Arizona MEDICAID 093229

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