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Individual

DR. MARK ROSS KOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
521 EDGEWATER RD, PASADENA, MD 21122-5633
(410) 255-7471
Mailing address
521 EDGEWATER RD, PASADENA, MD 21122-5633
(410) 255-7471

Taxonomy

Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
5985
MD

Other

Enumeration date
11/03/2014
Last updated
05/01/2017
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