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General NPI Number Information
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NPI Number | 1326393133
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Entity Type | Individual
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Provider Name | ELIZABETH ANN KOENIG D.D.S.
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Gender | Female
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Dates
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Enumeration Date | 07/18/2012
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Last Update Date | 07/18/2012
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Provider Practice Location Address
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Address Line | 699 HARRISBURG PIKE
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City | COLUMBUS
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State | OH
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Zip | 43223-2141
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Country | US
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Telephone | 614-276-1661
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Fax |
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Provider Business Mailing Address
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Address Line | 6359 LAKEVIEW CIR
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City | CANAL WINCHESTER
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State | OH
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Zip | 43110-1076
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Country | US
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Telephone | 330-763-4022
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 30.023447
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License Number State | OH
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