Organization
COOTHBRUSH INC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. TERRY ALAN MCCOOE DDS (CEO COOTHBRUSH INC)
(812) 738-2257
Entity
Organization
Contact information
Practice address
545 COUNTRY CLUB RD SE, CORYDON, IN 47112
(812) 738-2257
(812) 738-1778
Mailing address
545 COUNTRY CLUB RD SE, CORYDON, IN 47112
(812) 738-2257
(812) 738-1778
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
12007362
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
10007512A
—
IN
Enumeration date
11/24/2006
Last updated
08/22/2020
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