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Individual

DR. TOBY GREGORY COTHREN

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
DDS

Contact information

Practice address
812 PARK AVE, MANDEVILLE, LA 70448-4921
(985) 624-7400
Mailing address
4500 CLEVELAND PL, METAIRIE, LA 70003-1246
(504) 454-3687

Taxonomy

Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3265
LA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1832651
LA
Enumeration date
07/09/2006
Last updated
07/08/2007
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