Organization
B.L. COCKERHAM III & ASSOCIATES PLLC
Active
Other names
Southpark Periodontics
Organization subpart
No
Provider details
NPI number
Authorized official
BOBBY L COCKERHAM DDS (OWNER)
(704) 366-2774
Entity
Organization
Contact information
Practice address
6719 FAIRVIEW RD, CHARLOTTE, NC 28210-3879
(704) 366-2774
(704) 366-2639
Mailing address
6719 FAIRVIEW RD, CHARLOTTE, NC 28210-3879
(704) 366-2774
(704) 366-2639
Taxonomy
Speciality
Code
Description
License number
State
1223P0300X
Periodontics
4673
NC
1223P0300X
Periodontics
Primary
9124
NC
Other
Enumeration date
08/04/2016
Last updated
07/21/2023
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