Healthcare Provider Details

I. General information

NPI: 1558442970
Provider Name (Legal Business Name): PERRY L KOCHER DDS
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 10/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2020 LAUREL ST
COLUMBIA SC
29204-1019
US

IV. Provider business mailing address

2020 LAUREL ST
COLUMBIA SC
29204-1019
US

V. Phone/Fax

Practice location:
  • Phone: 803-254-4543
  • Fax: 803-779-3329
Mailing address:
  • Phone: 803-254-4543
  • Fax: 803-779-3329

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number2589
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: