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General NPI Number Information
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NPI Number | 1225447667
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Entity Type | Organization
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Legal Business Name | DR. DOUGLAS J. COCHRAN D.D.S. P.C.
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Dates
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Enumeration Date | 08/11/2014
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Last Update Date | 09/02/2014
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Provider Practice Location Address
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Address Line | 7101 N OAK TRFY
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City | GLADSTONE
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State | MO
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Zip | 64118-2514
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Country | US
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Telephone | 816-436-2150
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Fax | 816-436-2083
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Provider Business Mailing Address
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Address Line | 7101 N OAK TRFY
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City | GLADSTONE
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State | MO
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Zip | 64118-2514
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Country | US
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Telephone | 816-436-2150
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Fax | 816-436-2083
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. DOUGLAS JAMES COCHRAN
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Credential | D.D.S.
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Telephone | 18164362150
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 122300000X
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Taxonomy Name | Dentist
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License Number | 014180
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License Number State | MO
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