Individual provider · Type 1 NPI

Kennon Lee Koenig, DDS

Student in an Organized Health Care Education/Training Program · San Antonio, TX

NPI number 1245670942 Active

Practice location

7703 Floyd Curl Drive, Msc 7903, Ut Health Science Center At San Antonio, Agd Clinic
San Antonio, TX 78229-3000

Call (210) 567-3456 Map

Fax (210) 567-3443

Mailing address

7703 Floyd Curl Drive, Msc 7914, Ut Health Science Center At San Antonio
San Antonio, TX 78229-3000

Specialties and licenses

TaxonomyCodeLicense
Dentist 122300000X28961 (TX)
Student in an Organized Health Care Education/Training Program Primary 390200000X28961 (TX)

Student in an Organized Health Care Education/Training Program: An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

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About NPI 1245670942

Kennon Lee Koenig, DDS's National Provider Identifier is 1245670942, issued on Jun 27, 2013. The primary taxonomy on file is Student in an Organized Health Care Education/Training Program (390200000X), and the practice location is in San Antonio, TX. The record was last updated on Jun 27, 2013.