Provider Demographics
NPI:1861819641
Name:JOSHUA COCHRAN DMD PLLC
Entity Type:Organization
Organization Name:JOSHUA COCHRAN DMD PLLC
Other - Org Name:DR. C FAMILY DENTISTRY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSHUA
Authorized Official - Middle Name:R
Authorized Official - Last Name:COCHRAN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:206-755-6436
Mailing Address - Street 1:1014 W 21ST AVE
Mailing Address - Street 2:
Mailing Address - City:SPOKANE
Mailing Address - State:WA
Mailing Address - Zip Code:99203-1204
Mailing Address - Country:US
Mailing Address - Phone:206-755-6436
Mailing Address - Fax:
Practice Address - Street 1:13514 E 32ND AVE STE B
Practice Address - Street 2:
Practice Address - City:SPOKANE VALLEY
Practice Address - State:WA
Practice Address - Zip Code:99216-6002
Practice Address - Country:US
Practice Address - Phone:509-228-3834
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-03-18
Last Update Date:2014-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WADE 601 592 611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty