Individual
DR. ALIA KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DDS, MD
Contact information
Practice address
622 W 168TH ST, VC 7-ORAL AND MAXILLOFACIAL SURGERY FACULTY ASSOC, NEW YORK, NY 10032-3720
(212) 305-4552
Mailing address
180 FORT WASHINGTON AVENUE, HP8-805, NEW YORK, NY 10032
Taxonomy
Speciality
Code
Description
License number
State
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
052024
NY
208600000X
Surgery Physician
257552
NY
Other
Enumeration date
04/24/2007
Last updated
11/30/2024
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