Jason Mantle Koch D.M.D.

NPI 1649459264 - Dentist - 122300000X

NPI Details
NPI 1649459264
Gender Male
Enumeration Date 10/31/2007
Last Updated 10/31/2007
Entity Type Individual
Active Over 9 years ago
Practice Location
95 RAYWICK RD
ST MARY KY, 40063-8800, US
Phone (270) 699-4074
Fax
Business Location
100 CAMBRON DR
BARDSTOWN KY, 40004-2245, US
Phone (502) 460-2976
Fax
Toxanomy
Taxonomy Code 122300000X
License State Kentucky
License Number 7252
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According to our database, Dr. Jason Mantle Koch D.M.D. NPI is 1649459264, taxonomy code is 122300000X and license number is 7252, license state is located at Kentucky. Jason Mantle Koch D.M.D. physically located at 95 Raywick Rd, St Mary KY, 40063-8800. NPI Number Jason Mantle Koch D.M.D. has the Individual type.

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1649459264 NPI number is provided on an as is basis without warranty of any kind. 1649459264 is maintained by the National Plan & Provider Enumeration System. The contents of Jason Mantle Koch D.M.D. are for informational purposes only.