Individual
DR. RENAE BRADDY KOSHA
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
DDS
Contact information
Practice address
2821 NC-903 #093, MAURY, NC 28554
(252) 653-5765
Mailing address
103 MIMOSA PARK DR, GOLDSBORO, NC 27534-3225
(252) 945-8781
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
11359
NC
1223G0001X
General Practice Dentistry
11359
NC
Other
Enumeration date
05/22/2019
Last updated
06/06/2024
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