Organization
SAMUEL L. KOTH, DDS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. SAMUEL LEE KOTH DDS (DENTIST/PRESIDENT)
(712) 476-2749
Entity
Organization
Contact information
Practice address
1220 21ST AVE, ROCK VALLEY, IA 51247-1420
(712) 476-2749
(712) 476-5374
Mailing address
1220 21ST AVE, ROCK VALLEY, IA 51247-1420
(712) 476-2749
(712) 476-5374
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
08755
IA
Other
Enumeration date
10/08/2012
Last updated
10/08/2012
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