Individual
KAYLA N KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Contact information
Practice address
74 ECLIPSE CTR, BELOIT, WI 53511-3550
(608) 361-0311
Mailing address
74 ECLIPSE CTR, BELOIT, WI 53511-3550
(608) 361-0311
Taxonomy
Speciality
Code
Description
License number
State
124Q00000X
Dental Hygienist
Primary
11045-16
WI
Other
Enumeration date
03/07/2012
Last updated
03/07/2012
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