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General NPI Number Information
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NPI Number | 1114707189
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Entity Type | Organization
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Legal Business Name | CHRISTOPHER KOECHNER DMD
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Dates
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Enumeration Date | 10/05/2023
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Last Update Date | 10/05/2023
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Provider Practice Location Address
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Address Line | 1373 YMCA DR
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City | FESTUS
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State | MO
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Zip | 63028-2617
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Country | US
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Telephone | 636-937-6565
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Fax |
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Provider Business Mailing Address
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Address Line | 1373 YMCA DR
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City | FESTUS
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State | MO
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Zip | 63028-2617
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Country | US
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Telephone | 636-937-6565
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. CHRISTOPHER J KOECHNER
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Credential | DMD
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Telephone | 618-364-2411
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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