Provider Demographics
NPI:1851380075
Name:COCHRAN AND DARNELL DENTAL CORPORATION
Entity Type:Organization
Organization Name:COCHRAN AND DARNELL DENTAL CORPORATION
Other - Org Name:HOLLISTER CENTER FOR COSMETIC DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:W
Authorized Official - Last Name:DARNELL
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:831-637-4623
Mailing Address - Street 1:890 SUNSET DR
Mailing Address - Street 2:SUITE D-1A
Mailing Address - City:HOLLISTER
Mailing Address - State:CA
Mailing Address - Zip Code:95023-5641
Mailing Address - Country:US
Mailing Address - Phone:831-637-4623
Mailing Address - Fax:831-637-4730
Practice Address - Street 1:890 SUNSET DR
Practice Address - Street 2:SUITE D-1A
Practice Address - City:HOLLISTER
Practice Address - State:CA
Practice Address - Zip Code:95023-5641
Practice Address - Country:US
Practice Address - Phone:831-637-4623
Practice Address - Fax:831-637-4730
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-20
Last Update Date:2008-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA288501223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
CA28850OtherCOCHRAN CA DENTAL LICENSE
CA48899OtherDARNELL CA DENTAL LICENSE