Individual
DR. HEATHER RENEE KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S
Contact information
Practice address
1041 E STATE HIGHWAY 152, MUSTANG, OK 73064-5117
(405) 256-0037
Mailing address
508 SW 123RD PL, OKLAHOMA CITY, OK 73170-6040
(405) 640-5458
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
6195
OK
Other
Enumeration date
06/18/2010
Last updated
06/18/2010
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