| NPI | 1801955364 |
|---|---|
| Professional Name | KENNETH EUGENE KOENKE |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 1223G0001X Dentist, General Practice (Licence: ME 3792) |
| Additional Taxonomies | 1223G0001X Dentist, General Practice (Licence: MO 12625) |
| Enumeration Date | 2006-12-08 |
| Last Update Date | 2007-07-08 |