Provider Demographics
NPI:1053403147
Name:JOHN D COCHRAN DDS INC
Entity type:Organization
Organization Name:JOHN D COCHRAN DDS INC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOHN
Authorized Official - Middle Name:D
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:210-922-7792
Mailing Address - Street 1:5713 SOUTH FLORES
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78214
Mailing Address - Country:US
Mailing Address - Phone:210-922-2792
Mailing Address - Fax:210-922-7333
Practice Address - Street 1:5713 SOUTH FLORES
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78214
Practice Address - Country:US
Practice Address - Phone:210-922-2792
Practice Address - Fax:210-922-7333
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-28
Last Update Date:2008-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty