Provider Demographics
NPI:1063561314
Name:COCHRAN, JOEL E (DMD)
Entity type:Individual
Prefix:DR
First Name:JOEL
Middle Name:E
Last Name:COCHRAN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:101 E 1ST ST
Mailing Address - Street 2:
Mailing Address - City:SYLACAUGA
Mailing Address - State:AL
Mailing Address - Zip Code:35150-2543
Mailing Address - Country:US
Mailing Address - Phone:256-245-5635
Mailing Address - Fax:256-245-5829
Practice Address - Street 1:101 E 1ST ST
Practice Address - Street 2:
Practice Address - City:SYLACAUGA
Practice Address - State:AL
Practice Address - Zip Code:35150-2543
Practice Address - Country:US
Practice Address - Phone:256-245-5635
Practice Address - Fax:256-245-5829
Is Sole Proprietor?:No
Enumeration Date:2007-01-09
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL050537557122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist