Provider Demographics
NPI:1851469159
Name:COYNER & MCCONNELL DDS INC
Entity Type:Organization
Organization Name:COYNER & MCCONNELL DDS INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:GARY
Authorized Official - Middle Name:G
Authorized Official - Last Name:COYNER
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-642-8165
Mailing Address - Street 1:178 S VICTORIA AVE
Mailing Address - Street 2:SUITE B
Mailing Address - City:VENTURA
Mailing Address - State:CA
Mailing Address - Zip Code:93003
Mailing Address - Country:US
Mailing Address - Phone:805-642-8165
Mailing Address - Fax:805-656-1919
Practice Address - Street 1:178 S VICTORIA AVE
Practice Address - Street 2:SUITE B
Practice Address - City:VENTURA
Practice Address - State:CA
Practice Address - Zip Code:93003
Practice Address - Country:US
Practice Address - Phone:805-642-8165
Practice Address - Fax:805-656-1919
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-04
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA16130122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty