Individual
DR. CASEY LEE KOCHEVAR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
1446 HOVER STREET, SUITE #100, LONGMONT, CO 80501
(303) 684-9777
(720) 306-3517
Mailing address
1446 HOVER STREET, SUITE #100, LONGMONT, CO 80501
(303) 684-9777
(720) 306-3517
Taxonomy
Speciality
Code
Description
License number
State
1223D0001X
Public Health Dentistry
8471
CO
1223G0001X
General Practice Dentistry
8471
CO
1223G0001X
General Practice Dentistry
Primary
8471CO
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
78271045
—
CO
05
—
96800241
—
CO
Enumeration date
07/18/2005
Last updated
08/31/2012
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