Organization
JOHN C COSBY JR DMD PA
Active
Other names
Northeast Dental Associates
Organization subpart
No
Provider details
NPI number
Authorized official
MR. JOHN C COSBY JR. DMD (PRESIDENT OWNER)
(803) 754-9160
Entity
Organization
Contact information
Practice address
7346 PARKLANE ROAD, COLUMBIA, SC 29223
(803) 788-6691
(803) 865-6870
Mailing address
7346 PARKLANE ROAD, COLUMBIA, SC 29223
(803) 788-6691
(803) 865-6870
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
SC1677
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Z16778
—
SC
Enumeration date
06/10/2008
Last updated
06/10/2008
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