MEDICARE: DR. SUZANNE KEMP COCO D.D.S., M.D.S.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223P0700X	Prosthodontics	15	AR

General Provider Information

NPI Number	:	1093980740
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. SUZANNE KEMP COCO D.D.S., M.D.S.

Provider Business Mailing Address
First Line	:	8028 CANTRELL RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-2419
Country	:	US
Telephone Number	:	501-319-7520
Fax Number	:

Provider Business Practice Location Address
First Line	:	8028 CANTRELL RD
Second Line	:
City	:	LITTLE ROCK
State	:	AR
Zip	:	72227-2419
Country	:	US
Telephone Number	:	501-319-7520
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/24/2008
Last Update Date	:	04/20/2020

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