Provider Demographics
NPI:1902230436
Name:WILLIAM M. KOENIG, D.D.S., P.A.
Entity Type:Organization
Organization Name:WILLIAM M. KOENIG, D.D.S., P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:MARTIN
Authorized Official - Last Name:KOENIG
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:410-665-3300
Mailing Address - Street 1:8424 OLD HARFORD RD
Mailing Address - Street 2:SUITE 2A
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21234
Mailing Address - Country:US
Mailing Address - Phone:410-665-3300
Mailing Address - Fax:
Practice Address - Street 1:8424 OLD HARFORD RD
Practice Address - Street 2:SUITE 2A
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21234
Practice Address - Country:US
Practice Address - Phone:410-665-3300
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:WILLIAM M. KOENIG, D.D.S., P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2013-09-03
Last Update Date:2013-09-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDMD5441122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty