Cochran, Stephen Duane

Cochran, Stephen Duane is an individual health care provider with primary practice located at 8355 Bayberry Rd , Jacksonville FL 32256-4427. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Cochran, Stephen Duane can be contacted via phone (904) 733-7254.

Contact Information

Primary practice address
8355 Bayberry Rd Jacksonville FL 32256-4427
Fax: (904) 731-0144
Website:

Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X DN12667 Florida

Profile Details

NPI number 1639331382
LBN Legal business name Cochran, Stephen Duane
Credentials Doctor of Dental Medicine (DMD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 25th, 2008
Last updated Jun 25th, 2008 - about 17 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1639331382 NPPES
Georgia MEDICAID 00583877A
Georgia Other 69399
Georgia Other 825658
Georgia MEDICAID 074269400

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