Provider Demographics
NPI:1255316360
Name:COBB, HERMAN BRYAN (DDS,MS)
Entity Type:Individual
Prefix:DR
First Name:HERMAN
Middle Name:BRYAN
Last Name:COBB
Suffix:
Gender:M
Credentials:DDS,MS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:210 STAUNTON DR
Mailing Address - Street 2:
Mailing Address - City:GREENSBORO
Mailing Address - State:NC
Mailing Address - Zip Code:27410-6065
Mailing Address - Country:US
Mailing Address - Phone:336-292-5912
Mailing Address - Fax:336-288-9491
Practice Address - Street 1:2600 OAKCREST AVE
Practice Address - Street 2:BLDG A
Practice Address - City:GREENSBORO
Practice Address - State:NC
Practice Address - Zip Code:27408-1934
Practice Address - Country:US
Practice Address - Phone:336-288-9445
Practice Address - Fax:336-288-9491
Is Sole Proprietor?:Yes
Enumeration Date:2005-12-12
Last Update Date:2023-07-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC43311223P0221X
NCNC 43311223P0221X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223P0221XDental ProvidersDentistPediatric Dentistry
Provider Identifiers
StateIdentifier IDID TypeIssuer
NCAC7752404OtherBNDD NUMBER
NC91680Medicaid
NC91680Medicaid