Individual
DR. KIMBERLY A KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.D.S.
Contact information
Practice address
3715 S MADISON ST, MUNCIE, IN 47302-5756
(765) 281-4257
(765) 213-2769
Mailing address
3715 S MADISON ST, PO BOX 1676, MUNCIE, IN 47302-5756
(765) 281-4257
(765) 213-2769
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12010451A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
200386460
—
IN
Enumeration date
12/28/2005
Last updated
06/01/2011
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