Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | 2901021936 | MI |
NPI | 1073963831 |
---|---|
Provider Name | Dr. Trevor Allen Coeling |
First Address | West Branch, MI 48661-9383 |
Second Address | West Branch, MI 48661-9383 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 13/06/2016 |
Last Update Date | 02/12/2016 |