Cockley, Jackson

Cockley, Jackson is an individual health care provider with primary practice located at 1145 Aspira Ct , Mansfield OH 44906-4125. He recently has only one registered license in Dental Providers / Pediatric Dentistry, which is considered as his primary health care specialty. Cockley, Jackson can be contacted via phone (419) 774-7529.

Contact Information

Primary practice address
1145 Aspira Ct Mansfield OH 44906-4125
Phone: (419) 774-7529
Fax: (419) 774-7529
Website:
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Health care specialties

SpecialtyCodeLicense #State
Dental Providers / Pediatric Dentistry 1223P0221X 30021945 Ohio

Profile Details

NPI number 1487740114
LBN Legal business name Cockley, Jackson
Credentials Doctor of Dental Surgery (DDS)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 4th, 2006
Last updated Jan 3rd, 2012 - about 13 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 1487740114 NPPES
Ohio MEDICAID 2704818

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