Provider Demographics
NPI:1558584151
Name:KOCHENOUR, WILLIAM LEWIS II (DDS,MS,PA)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:LEWIS
Last Name:KOCHENOUR
Suffix:II
Gender:M
Credentials:DDS,MS,PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3005 ENTERPRISE RD E
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:FL
Mailing Address - Zip Code:33759-1304
Mailing Address - Country:US
Mailing Address - Phone:727-796-2456
Mailing Address - Fax:727-796-8364
Practice Address - Street 1:3005 ENTERPRISE RD E
Practice Address - Street 2:
Practice Address - City:CLEARWATER
Practice Address - State:FL
Practice Address - Zip Code:33759-1304
Practice Address - Country:US
Practice Address - Phone:727-796-2456
Practice Address - Fax:727-796-8364
Is Sole Proprietor?:No
Enumeration Date:2007-04-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLDN00088891223X0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223X0400XDental ProvidersDentistOrthodontics and Dentofacial Orthopedics