Dr. Bradley S Koch
Oral and Maxillofacial Surgeon
2353 S Ridge Rd
Green Bay
, Wisconsin 54304-5069
Dr. Bradley S Koch
Oral and Maxillofacial Surgeon
2353 S Ridge Rd
Green Bay
, Wisconsin 54304-5069
(920) 499-8312
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About
Features
Specialties
- Oral and Maxillofacial Surgeon
Languages spoken
- English
Location
First Address
- Dr. Bradley S Koch
- 2353 S Ridge Rd
- Green Bay, WI
- Zip : 54304-5069
- Fax : (920) 499-8312
- Phone : (920) 499-0471
Second Address
- Dr. Bradley S Koch
- 2353 S Ridge Rd
- Green Bay, WI
- Zip : 54304-5069
- Fax : (920) 499-8312
- Phone : (920) 499-0471
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FAQs
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Is Dr. Bradley S Koch a sole practitioner?
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 1223S0112X | Oral and Maxillofacial Surgeon | 4005-015 | WI |
National Provider Identifier
| NPI | 1013921196 |
|---|---|
| Provider Name | Dr. Bradley S Koch |
| First Address | Green Bay, WI 54304-5069 |
| Second Address | Green Bay, WI 54304-5069 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 27/07/2006 |
| Last Update Date | 08/07/2007 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| U90904 | (02) | WI |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.