Provider Demographics
NPI:1750080750
Name:COCODENTAL LLC
Entity type:Organization
Organization Name:COCODENTAL LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGER
Authorized Official - Prefix:DR
Authorized Official - First Name:JOY
Authorized Official - Middle Name:LYNN
Authorized Official - Last Name:EAKINS
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:360-708-7790
Mailing Address - Street 1:721 US HIGHWAY 1 STE 106
Mailing Address - Street 2:
Mailing Address - City:NORTH PALM BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:33408-4519
Mailing Address - Country:US
Mailing Address - Phone:561-855-4703
Mailing Address - Fax:
Practice Address - Street 1:721 US HIGHWAY 1 STE 106
Practice Address - Street 2:
Practice Address - City:NORTH PALM BEACH
Practice Address - State:FL
Practice Address - Zip Code:33408-4519
Practice Address - Country:US
Practice Address - Phone:561-855-4703
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-02-28
Last Update Date:2023-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty