Bradley S Koch in Green Bay - Oral And Maxillofacial Surgery
Bradley S Koch - NPI 1013921196
Bradley S Koch is a Oral And Maxillofacial Surgery in Green Bay, Wisconsin. Bradley S Koch practices all healthcare services and medical treatments related to Oral And Maxillofacial Surgery. The NPI Number for Bradley S Koch is 1013921196. The last update date is 2007-07-08.
Bradley S Koch's current location address is 2353 S Ridge Rd, Green Bay, Wisconsin. You can contact this provider via phone number 9204990471 and fax number 9204998312. The mailing address for Bradley S Koch is 2353 S Ridge Rd, Green Bay, Wisconsin. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Bradley S Koch |
|---|---|
| Address | 2353 S Ridge Rd, Green Bay, Wisconsin |
| Phone Number | 9204990471 |
| Fax Number | 9204998312 |
| Sole Proprietor | N |
| Credentials | D.D.S. |
NPI Number Detail
| NPI Number | 1013921196 |
|---|---|
| Provider Enumeration Date | 2006-07-27 |
| Last Updated Date | 2007-07-08 |
Provider Mailing Address Detail
| Address | 2353 S Ridge Rd |
|---|---|
| City | Green Bay |
| State | Wisconsin (WI) |
| Post Code | 543045069 |
| Phone Number | 9204990471 |
| Fax Number | 9204998312 |
Provider's Primary Taxonomy Detail
| Speciality | Oral And Maxillofacial Surgery |
|---|---|
| Taxonomy | 1223S0112X |
| Licence No | 4005-015 |
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Definition: The specialty of dentistry which includes the diagnosis, surgical and adjunctive treatment of diseases, injuries and defects involving both the functional and esthetic aspects of the hard and soft tissues of the oral and maxillofacial region. |
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Post Comment/ Review Below
What is the unique identifier code issued to Bradley S Koch by the Centers for Medicare & Medicaid Services?
The Bradley S Koch has been assigned the NPI (National Provider Identifier) 1013921196. This 10-digit code serves as a unique identification number for healthcare providers issued by the Centers for Medicare & Medicaid Services (CMS).
Could you kindly provide the complete physical address where Bradley S Koch's facilities are geographically located?
The facilities of Bradley S Koch are physically situated at the following location: 2353 S Ridge Rd, Green Bay, WI, 543045069.
What is Bradley S Koch's area of expertise and its corresponding taxonomy classification?
The Bradley S Koch's field of specialization is Oral And Maxillofacial Surgery, and it falls under the taxonomy code 1223S0112X, which categorizes healthcare providers based on their areas of practice.
On what date did the Bradley S Koch receive its 1013921196 assignment from the Centers for Medicare & Medicaid Services?
The Bradley S Koch was assigned its 1013921196 by the Centers for Medicare & Medicaid Services on 2006-07-27.
As of what date were the Bradley S Koch's details last updated?
The information pertaining to the Bradley S Koch, including its address, specialty, and other details, was most recently updated on 2007-07-08.