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Individual

DR. KEITH WILLIAM KOCH

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
D.D.S.

Contact information

Practice address
4376 LAKEVILLE RD., GENESEO, NY 14454
(585) 243-3174
(585) 243-3333
Mailing address
4376 LAKEVILLE RD., PO BOX 186, GENESEO, NY 14454
(585) 243-3174
(585) 243-3333

Taxonomy

Speciality
Code
Description
License number
State
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
040183-1
NY

Other

Enumeration date
05/03/2007
Last updated
07/08/2007
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