Provider Demographics
NPI:1295805158
Name:KOENIG, DAVID A (DDS)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:A
Last Name:KOENIG
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 W NORTHFIELD RD
Mailing Address - Street 2:SUITE 210B
Mailing Address - City:LIVINGSTON
Mailing Address - State:NJ
Mailing Address - Zip Code:07039-3789
Mailing Address - Country:US
Mailing Address - Phone:973-535-0800
Mailing Address - Fax:973-535-8783
Practice Address - Street 1:2 W NORTHFIELD RD
Practice Address - Street 2:SUITE 210B
Practice Address - City:LIVINGSTON
Practice Address - State:NJ
Practice Address - Zip Code:07039-3789
Practice Address - Country:US
Practice Address - Phone:973-535-0800
Practice Address - Fax:973-535-8783
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-08
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJDI126111223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice