Provider Demographics
NPI:1760535934
Name:KOENIG, HANS (DMD)
Entity Type:Individual
Prefix:DR
First Name:HANS
Middle Name:
Last Name:KOENIG
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:500 NORTH SEMORAN BLVD.
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32807
Mailing Address - Country:US
Mailing Address - Phone:407-277-6272
Mailing Address - Fax:407-277-5926
Practice Address - Street 1:500 NORTH SEMORAN BLVD.
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32807
Practice Address - Country:US
Practice Address - Phone:407-277-6272
Practice Address - Fax:407-277-5926
Is Sole Proprietor?:No
Enumeration Date:2007-01-19
Last Update Date:2012-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PA0368221223G0001X
FLDN184721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice