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Ben Koolick, DDS
NPI 1104818467 · on the registry since 2005 · sole proprietor
Practice
- Address
- 8390 W Cactus Rd Ste 110
Peoria, AZ 85381 - Phone
- (623) 878-3300
- Organisation at this address
- Supervista North America
Inferred from a shared address, not stated in the registry.
- Clinicians at this address
- 2
Registry record
- Primary taxonomy
- General Practice Dentistry
1223G0001X
- Licence states on file
- AZ
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2011-04-03
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in Arizona