Provider Demographics
NPI:1952521213
Name:COGGIN, CHERRY CELESTE (DMD)
Entity Type:Individual
Prefix:DR
First Name:CHERRY
Middle Name:CELESTE
Last Name:COGGIN
Suffix:
Gender:F
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:4624 COLUMNS DR SE
Mailing Address - Street 2:
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30067-4680
Mailing Address - Country:US
Mailing Address - Phone:770-984-0123
Mailing Address - Fax:770-952-5842
Practice Address - Street 1:2024 POWERS FERRY RD SE
Practice Address - Street 2:SUITE 190
Practice Address - City:ATLANTA
Practice Address - State:GA
Practice Address - Zip Code:30339-5049
Practice Address - Country:US
Practice Address - Phone:770-953-6666
Practice Address - Fax:770-952-5842
Is Sole Proprietor?:No
Enumeration Date:2007-04-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA0096741223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice