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General NPI Number Information
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NPI Number | 1578630042
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Entity Type | Organization
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Legal Business Name | BOCKIAN & COWAN D.D.S. P.A,
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Dates
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Enumeration Date | 11/29/2006
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Last Update Date | 08/22/2020
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Provider Practice Location Address
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Address Line | 17027 PINES BLVD
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City | PEMBROKE PINES
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State | FL
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Zip | 33027-1003
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Country | US
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Telephone | 954-704-0044
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Fax | 954-704-8302
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Provider Business Mailing Address
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Address Line | 1550 BREAKWATER TER
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City | HOLLYWOOD
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State | FL
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Zip | 33019-5023
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Country | US
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Telephone | 954-704-0044
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Fax | 954-704-8302
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Authorized Official
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Title or Position | CO-OWNER
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Name | DR. JOSHUA BOCKIAN
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Credential | DDS
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Telephone | 954-704-0044
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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 | DN6296
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License Number State | FL
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