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General NPI Number Information
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NPI Number | 1407361827
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Entity Type | Organization
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Legal Business Name | NICHOLAS KOCHENOUR DMD MSD LLC
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Dates
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Enumeration Date | 12/07/2017
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Last Update Date | 12/07/2017
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Provider Practice Location Address
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Address Line | 1418 OH-60 SUITE 1
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City | VERMILION
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State | OH
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Zip | 44089
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Country | US
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Telephone | 440-967-0186
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Fax |
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Provider Business Mailing Address
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Address Line | 4185 SILSBY RD
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City | UNIVERSITY HEIGHTS
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State | OH
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Zip | 44118-3327
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | NICHOLAS S KOCHENOUR
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Credential | DMD
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Telephone | 252-258-3724
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number |
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License Number State |
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