Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223E0200X | Endodontist | 48932 | CA |
NPI | 1033246434 |
---|---|
Provider Name | Dr. David P. Koehn |
First Address | El Dorado Hills, CA 95762-9326 |
Second Address | El Dorado Hills, CA 95762-9326 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 27/02/2007 |
Last Update Date | 23/01/2008 |