Individual
DR. KERRY P COGBURN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S. P.A.
Contact information
Practice address
418 JONES COVE RD, CLYDE, NC 28721-9458
(828) 627-9285
(828) 627-9287
Mailing address
272 STONEY BROOK DR, CLYDE, NC 28721-8537
(828) 627-6412
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3906
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991701
—
NC
Enumeration date
07/03/2006
Last updated
07/08/2007
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