NPI 1023117629

Philip Erich Koch, DMD

Practitioner Oral and Maxillofacial Surgery (Dentist) Gainesville, GA

Practice location

Address: 1221 Sherwood Park Drive Suite B, Gainesville, GA 30501
Phone: (770) 534-1492
Fax: (770) 534-8309

Registered specialties

Oral and Maxillofacial Surgery (Dentist) Primary

Dental Providers Taxonomy 1223S0112X Licence 8279 (GA)

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Registry record

NPI: 1023117629
Entity type: Individual
Sex (as registered): Male
NPI issued: 21 Sep 2006
Record last updated: 23 Mar 2017

Reproduced from NPPES, the federal provider registry. The date above is when the provider last updated their own entry, not when we fetched it - a record can be years old and still current in the registry.