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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

PROF. TAKASHI KOYAMA, DMD, PHD FACS

Active

PROF. TAKASHI KOYAMA, DMD, PHD FACS is a Oral & Maxillofacial Surgery (Physician) healthcare provider located in FORT PIERCE, Florida. NPI 1356459028 is currently active in the NPPES registry. Verify at CMS.

Oral & Maxillofacial Surgery (Physician) · FORT PIERCE, FL

Registration Details

NPI Number
1356459028
Provider Type
Individual
Gender
Male
NPI Issued
Aug 25, 2006 (19.999996943728 yrs)
Last Updated
Jul 16, 2019
Licenses
DN16376 (FL)
DN16376 (FL)

Practice Information

Address
2402 FRIST BLVD STE 100
FORT PIERCE, FL, 349504838
Browse FL providers · Browse ZIP 34950
Phone
7724619700
Fax
7724619300
Primary Specialty
Oral & Maxillofacial Surgery (Physician)
204E00000X
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.