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BOB KOENITZER DDS INC. NPI 1063690436


NPI Information

NPI: 1063690436
Provider Name: BOB KOENITZER DDS, INC.
Classification: Dentist - 1223G0001X
Entity Type: Organization

Specialization: General Practice

Address:
101 LYNCH CREEK WAY
PETALUMA, CA
ZIP 94954
Phone: (707) 766-6666
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BOB KOENITZER DDS, INC. is a general practice dentist in Petaluma, CA. The provider is a general dentist is the primary dental care provider for patients of all ages. The general dentist is responsible for the diagnosis, treatment, management and overall coordination of services related to patients' oral health needs. BOB KOENITZER DDS, INC. NPI is 1063690436. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

101 LYNCH CREEK WAY
PETALUMA, CA
ZIP 94954-301
Phone: (707) 766-6666
Fax: (707) 763-1614

The provider's authorized official is Bob David Koenitzer .
The authorized official title is Owner and has the following contact phone number (707) 766-6666.

The enumeration date for this NPI number is 2/7/2008 and was last updated on 2/7/2008.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11223G0001XDentistGeneral Practice34624CALIFORNIAYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

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