Healthcare Provider Details

I. General information

NPI: 1235360439
Provider Name (Legal Business Name): KOCHER & KOCHER DENTISTRY PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/05/2009
Last Update Date: 08/05/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4801 S UNIVERSITY DR STE 112
DAVIE FL
33328-3835
US

IV. Provider business mailing address

4801 S UNIVERSITY DR STE 112
DAVIE FL
33328-3835
US

V. Phone/Fax

Practice location:
  • Phone: 954-434-0600
  • Fax:
Mailing address:
  • Phone: 954-434-0600
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN17970
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License NumberDN 18328
License Number StateFL

VIII. Authorized Official

Name: DR. MICHAEL JOSEPH KOCHER
Title or Position: CO-PRESIDENT
Credential: DMD
Phone: 954-434-0600