Individual
DR. BRETT E COTHAM
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
614 E 32ND ST, JOPLIN, MO 64804-3905
(417) 781-6322
Mailing address
614 E 32ND STREET, JOPLIN, MO 64804
(417) 781-6322
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
2012015653
MO
122300000X
Dentist
Primary
3886
AR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2012015653
STATE LICENSE
MO
01
—
3886
STATE LICENSE
AR
Enumeration date
07/02/2012
Last updated
02/05/2024
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