Provider Demographics
NPI:1972650422
Name:ALBERT C COCO DDS PC
Entity Type:Organization
Organization Name:ALBERT C COCO DDS PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ALBERT
Authorized Official - Middle Name:CARL
Authorized Official - Last Name:COCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:402-493-2314
Mailing Address - Street 1:1915 NO 121ST STREET
Mailing Address - Street 2:SUITE A
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:69154
Mailing Address - Country:US
Mailing Address - Phone:402-493-2314
Mailing Address - Fax:402-493-6063
Practice Address - Street 1:1915 NO 121ST STREET
Practice Address - Street 2:SUITE A
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:69154
Practice Address - Country:US
Practice Address - Phone:402-493-2314
Practice Address - Fax:402-493-6063
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE3801122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Multi-Specialty