Provider Demographics
NPI:1942369228
Name:SOENEN, DAN F (DDS,PC)
Entity Type:Individual
Prefix:DR
First Name:DAN
Middle Name:F
Last Name:SOENEN
Suffix:
Gender:M
Credentials:DDS,PC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:508 N BIRCH ST
Mailing Address - Street 2:
Mailing Address - City:KALKASKA
Mailing Address - State:MI
Mailing Address - Zip Code:49646-8414
Mailing Address - Country:US
Mailing Address - Phone:231-258-5395
Mailing Address - Fax:231-258-8010
Practice Address - Street 1:508 N BIRCH ST
Practice Address - Street 2:
Practice Address - City:KALKASKA
Practice Address - State:MI
Practice Address - Zip Code:49646-8414
Practice Address - Country:US
Practice Address - Phone:231-258-5395
Practice Address - Fax:231-258-8010
Is Sole Proprietor?:No
Enumeration Date:2006-12-06
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI118641223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice