| Bob Koenitzer Dds, Inc. | |
|
101 Lynch Creek Way Petaluma CA 94954-8301 | |
| (707) 766-6666 | |
| (707) 763-1614 |
| Full Name | Bob Koenitzer Dds, Inc. |
|---|---|
| Speciality | Dentist - General Practice |
| Location | 101 Lynch Creek Way, Petaluma, California |
| Authorized Official Name and Position | Bob David Koenitzer (OWNER) |
| Authorized Official Contact | 7077666666 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Bob Koenitzer Dds, Inc. 101 Lynch Creek Way Petaluma CA 94954-8301 Ph: (707) 766-6666 | Bob Koenitzer Dds, Inc. 101 Lynch Creek Way Petaluma CA 94954-8301 Ph: (707) 766-6666 |
| NPI Number | 1063690436 |
|---|---|
| Provider Enumeration Date | 02/07/2008 |
| Last Update Date | 02/07/2008 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063690436 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1223G0001X | Dentist - General Practice | 34624 (California) | Primary |
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