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General NPI Number Information
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NPI Number | 1184389454
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Entity Type | Individual
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Provider Name | JUAN CARLOS COBOS DMD
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Gender | Male
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Dates
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Enumeration Date | 11/02/2021
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Last Update Date | 12/11/2024
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Provider Practice Location Address
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Address Line | 1713 WESTON BRENT LN
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City | EL PASO
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State | TX
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Zip | 79935-3013
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Country | US
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Telephone | 915-592-2097
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Fax |
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Provider Business Mailing Address
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Address Line | 401 FIRST ST
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City | SUNLAND PARK
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State | NM
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Zip | 88063-9146
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Country | US
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Telephone | 915-892-9252
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | 39294
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License Number State | TX
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Taxonomy #2
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number | DD5552
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License Number State | NM
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