Individual
DR. KELLY KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DMD
Contact information
Practice address
56 NEW DRIFTWAY, SCITUATE, MA 02066-4533
(781) 545-5102
Mailing address
1 NASSAU ST APT 807, BOSTON, MA 02111-1554
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
1857617
MA
Other
Enumeration date
06/13/2017
Last updated
06/13/2017
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