Provider Demographics
NPI:1285040972
Name:COCHRAN, GARRET THOMAS (DDS)
Entity Type:Individual
Prefix:DR
First Name:GARRET
Middle Name:THOMAS
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7101 N OAK TRFY
Mailing Address - Street 2:
Mailing Address - City:GLADSTONE
Mailing Address - State:MO
Mailing Address - Zip Code:64118-2514
Mailing Address - Country:US
Mailing Address - Phone:816-436-2150
Mailing Address - Fax:
Practice Address - Street 1:7101 N OAK TRFY
Practice Address - Street 2:
Practice Address - City:GLADSTONE
Practice Address - State:MO
Practice Address - Zip Code:64118-2514
Practice Address - Country:US
Practice Address - Phone:816-436-2150
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-02
Last Update Date:2014-07-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO20140194161223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice