Individual
BRIAN D KOCH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.M.D.
Contact information
Practice address
11400 SE 37TH AVE, MILWAUKIE, OR 97222-5982
(503) 774-6355
Mailing address
11400 SE 37TH AVE, MILWAUKIE, OR 97222-5982
(503) 774-6355
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
D8295
OR
Other
Enumeration date
05/27/2006
Last updated
05/20/2015
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