Provider Demographics
NPI:1770760696
Name:DR WILLIAM J COCO, PA
Entity type:Organization
Organization Name:DR WILLIAM J COCO, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:JOSEPH
Authorized Official - Last Name:COCO
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:252-355-7178
Mailing Address - Street 1:500 RED BANKS RD STE A
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:27858-5759
Mailing Address - Country:US
Mailing Address - Phone:252-355-7178
Mailing Address - Fax:
Practice Address - Street 1:500 RED BANKS RD STE A
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:NC
Practice Address - Zip Code:27858-5759
Practice Address - Country:US
Practice Address - Phone:252-355-7178
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-01-22
Last Update Date:2008-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC53851223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty