Provider Demographics
NPI:1942697065
Name:FRED ZOCH DDS
Entity Type:Organization
Organization Name:FRED ZOCH DDS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:
Authorized Official - First Name:FRED
Authorized Official - Middle Name:FRANKLIN
Authorized Official - Last Name:ZOCH
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:409-735-7108
Mailing Address - Street 1:2525 TEXAS AVE
Mailing Address - Street 2:
Mailing Address - City:BRIDGE CITY
Mailing Address - State:TX
Mailing Address - Zip Code:77611-2847
Mailing Address - Country:US
Mailing Address - Phone:409-735-7108
Mailing Address - Fax:409-735-6596
Practice Address - Street 1:2525 TEXAS AVE
Practice Address - Street 2:
Practice Address - City:BRIDGE CITY
Practice Address - State:TX
Practice Address - Zip Code:77611-2847
Practice Address - Country:US
Practice Address - Phone:409-735-7108
Practice Address - Fax:406-735-6596
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-04-16
Last Update Date:2015-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX159551223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty