Provider Demographics
NPI:1033246434
Name:KOEHN, DAVID P (DDS)
Entity Type:Individual
Prefix:DR
First Name:DAVID
Middle Name:P
Last Name:KOEHN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1158 SUNCAST LN
Mailing Address - Street 2:
Mailing Address - City:EL DORADO HILLS
Mailing Address - State:CA
Mailing Address - Zip Code:95762-9326
Mailing Address - Country:US
Mailing Address - Phone:916-941-9888
Mailing Address - Fax:916-358-5638
Practice Address - Street 1:1158 SUNCAST LN
Practice Address - Street 2:
Practice Address - City:EL DORADO HILLS
Practice Address - State:CA
Practice Address - Zip Code:95762-9326
Practice Address - Country:US
Practice Address - Phone:916-941-9888
Practice Address - Fax:916-358-5638
Is Sole Proprietor?:No
Enumeration Date:2007-02-27
Last Update Date:2008-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA489321223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223E0200XDental ProvidersDentistEndodontics