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NPI Code Detail

MEDICARE: DR. FRANK KOE D.D.S.

MEDICARE: DR. FRANK KOE D.D.S.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1122300000XDentistIL

General Provider Information

NPI Number : 1518172212
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. FRANK KOE D.D.S.
Provider Business Mailing Address
First Line : 1604 VISA DR
Second Line : #3
City : NORMAL
State : IL
Zip : 61761-2195
Country : US
Telephone Number : 309-454-4321
Fax Number :
Provider Business Practice Location Address
First Line : 1604 VISA DR
Second Line : #3
City : NORMAL
State : IL
Zip : 61761-2195
Country : US
Telephone Number : 309-454-4321
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/14/2007
Last Update Date : 07/08/2007

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Directions to “ DR. FRANK KOE D.D.S.” Practice Location

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