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Organization

COCKLEY'S PLAYTIME DENTAL

Active
Other names
Playtime Dental
Organization subpart
No

Provider details

NPI number
Authorized official
DR. JACKSON COCKLEY DDS (DENTIST/PRESIDENT)
(419) 774-7529
Entity
Organization

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

Enumeration date
09/28/2010
Last updated
12/28/2011
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