Individual
DR. MARK LLEWELLYN KOCHEVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
1513 RIVERSIDE AVE, FORT COLLINS, CO 80524-4348
(970) 221-5090
(970) 221-1879
Mailing address
1513 RIVERSIDE AVE, FORT COLLINS, CO 80524-4348
(970) 221-5090
(970) 221-1879
Taxonomy
Speciality
Code
Description
License number
State
1223E0200X
Endodontics
Primary
CO6445
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
02064459
—
CO
05
—
113973800
—
WY
Enumeration date
07/11/2005
Last updated
09/02/2008
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