Individual
DR. JACKSON COCKLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1145 ASPIRA CT, MANSFIELD, OH 44906-4125
(419) 774-7529
(419) 774-7529
Mailing address
1145 ASPIRA CT, MANSFIELD, OH 44906-4125
(419) 774-7529
(419) 774-7529
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
Primary
30021945
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
2704818
—
OH
Enumeration date
10/04/2006
Last updated
01/03/2012
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