MEDICARE: DR. GARRET THOMAS COCHRAN DDS

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	1223G0001X	General Practice Dentistry	2014019416	MO

General Provider Information

NPI Number	:	1285040972
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. GARRET THOMAS COCHRAN DDS

Provider Business Mailing Address
First Line	:	7101 N OAK TRFY
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-2514
Country	:	US
Telephone Number	:	816-436-2150
Fax Number	:

Provider Business Practice Location Address
First Line	:	7101 N OAK TRFY
Second Line	:
City	:	GLADSTONE
State	:	MO
Zip	:	64118-2514
Country	:	US
Telephone Number	:	816-436-2150
Fax Number	:

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

Provider Enumeration Date	:	07/02/2014
Last Update Date	:	07/02/2014

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