Organization
DR. JERRY E. COHRON PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
ELISHA D SMITH (OFFICE MANAGER)
(270) 745-0698
Entity
Organization
Contact information
Practice address
948 ELM ST, SUITE 2, BOWLING GREEN, KY 42101-2277
(270) 745-0698
(270) 745-0067
Mailing address
948 ELM ST, SUITE 2, BOWLING GREEN, KY 42101-2277
(270) 745-0698
(270) 745-0067
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
4043
KY
1223S0112X
Oral and Maxillofacial Surgery (Dentist)
Primary
4043
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
60040433
—
KY
05
—
64040439
—
KY
Enumeration date
02/17/2012
Last updated
02/17/2012
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