Organization
KERRY P. COGBURN, DDS, PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KERRY P COGBURN DDS,PA (DENTIST)
(828) 627-9285
Entity
Organization
Contact information
Practice address
418 JONES COVE RD, CLYDE, NC 28721-9458
(828) 627-9285
(828) 627-9287
Mailing address
418 JONES COVE RD, CLYDE, NC 28721-9458
(828) 627-9285
(828) 627-9287
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
3906
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8991701
—
NC
Enumeration date
04/08/2008
Last updated
04/08/2008
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