Healthcare Provider Details

I. General information

NPI: 1851610281
Provider Name (Legal Business Name): JOSEPH L COWART DMD PA
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/25/2010
Last Update Date: 01/14/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4 MARKET ST STE 4202
BREVARD NC
28712-5637
US

IV. Provider business mailing address

4 MARKET ST STE 4202
BREVARD NC
28712-5637
US

V. Phone/Fax

Practice location:
  • Phone: 828-884-3702
  • Fax: 828-877-4065
Mailing address:
  • Phone: 828-884-3702
  • Fax: 828-877-4065

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4555
License Number StateNC

VIII. Authorized Official

Name: DR. JOSEPH COWART
Title or Position: PRESIDENT
Credential: DMD
Phone: 828-884-3702