Individual
STEPHEN COOKSON COUGILL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
8151 EAST 21ST STREET, INDIANAPOLIS, IN 46219-2513
(317) 897-2666
(317) 897-8436
Mailing address
8151 EAST 21ST STREET, INDIANAPOLIS, IN 46219-2513
(317) 897-2666
Taxonomy
Speciality
Code
Description
License number
State
122300000X
Dentist
Primary
12006383A
IN
Other
Enumeration date
09/14/2006
Last updated
07/08/2007
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