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General NPI Number Information
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NPI Number | 1366116006
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Entity Type | Organization
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Legal Business Name | JOSH COCHRAN 8382 PLLC
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Dates
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Enumeration Date | 08/05/2021
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Last Update Date | 08/05/2021
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Provider Practice Location Address
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Address Line | 8382 N WAYNE DR
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City | HAYDEN
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State | ID
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Zip | 83835-6028
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Country | US
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Telephone | 509-475-1362
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Fax |
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Provider Business Mailing Address
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Address Line | 13514 E 32ND AVE
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City | SPOKANE VALLEY
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State | WA
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Zip | 99216-6002
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | JOSHUA RIVER COCHRAN
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Credential | DMD
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Telephone | 206-755-6436
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number |
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License Number State |
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