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General NPI Number Information
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NPI Number | 1689164816
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Entity Type | Individual
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Provider Name | CHRISTOPHER JOHN KOECHNER DMD
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Gender | Male
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Dates
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Enumeration Date | 05/14/2018
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Last Update Date | 12/19/2020
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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 | 636-642-0696
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Provider Business Mailing Address
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Address Line | 5120 ROMAINE SPRING DR
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City | FENTON
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State | MO
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Zip | 63026-5865
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Country | US
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Telephone | 618-364-2411
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 10147
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License Number State | KY
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Taxonomy #2
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Taxonomy Code | 390200000X
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Taxonomy Name | Student in an Organized Health Care Education/Training Program
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License Number |
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License Number State |
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Taxonomy #3
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 2019007234
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License Number State | MO
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