Provider Demographics
NPI:1235878109
Name:KOSCH, ANNA CAROLINE (DDS)
Entity Type:Individual
Prefix:
First Name:ANNA
Middle Name:CAROLINE
Last Name:KOSCH
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 1:5235 MIDDLEBROOK DR NW
Mailing Address - Street 2:
Mailing Address - City:ROCHESTER
Mailing Address - State:MN
Mailing Address - Zip Code:55901-5583
Mailing Address - Country:US
Mailing Address - Phone:507-319-9606
Mailing Address - Fax:
Practice Address - Street 1:1011 BEL AIR LN NW
Practice Address - Street 2:
Practice Address - City:ROCHESTER
Practice Address - State:MN
Practice Address - Zip Code:55901-6992
Practice Address - Country:US
Practice Address - Phone:507-288-1188
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-05-31
Last Update Date:2023-04-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MND14727122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist