Provider Demographics
NPI:1154439685
Name:BOCKRATH, ANN A (DDS)
Entity Type:Individual
Prefix:DR
First Name:ANN
Middle Name:A
Last Name:BOCKRATH
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4353 E STATE ROUTE 73
Mailing Address - Street 2:STE 110
Mailing Address - City:WAYNESVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:45068-8814
Mailing Address - Country:US
Mailing Address - Phone:513-897-0248
Mailing Address - Fax:513-897-0249
Practice Address - Street 1:4353 E ST RT 73
Practice Address - Street 2:
Practice Address - City:WAYNESVILLE
Practice Address - State:OH
Practice Address - Zip Code:45068
Practice Address - Country:US
Practice Address - Phone:513-897-0248
Practice Address - Fax:513-897-0249
Is Sole Proprietor?:No
Enumeration Date:2006-08-25
Last Update Date:2016-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH30020084122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist