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General NPI Number Information
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NPI Number | 1942478953
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Entity Type | Individual
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Provider Name | JENNIFER CAITLYN KOCHER DMD
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Gender | Female
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Dates
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Enumeration Date | 02/12/2008
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Last Update Date | 02/12/2008
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Provider Practice Location Address
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Address Line | 12300 S SHORE BLVD STE 208
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City | WELLINGTON
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State | FL
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Zip | 33414-6237
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Country | US
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Telephone | 561-204-4494
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Fax |
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Provider Business Mailing Address
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Address Line | 8025 SW 21ST PL
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City | DAVIE
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State | FL
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Zip | 33324-5525
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Country | US
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Telephone | 352-246-7433
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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 | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DN 17970
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License Number State | FL
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