Provider Demographics
NPI:1396342762
Name:COCHRANE, LEONARD JAMES III (DMD)
Entity type:Individual
Prefix:DR
First Name:LEONARD
Middle Name:JAMES
Last Name:COCHRANE
Suffix:III
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 1:4610 OLEANDER DR STE 102
Mailing Address - Street 2:
Mailing Address - City:MYRTLE BEACH
Mailing Address - State:SC
Mailing Address - Zip Code:29577-5752
Mailing Address - Country:US
Mailing Address - Phone:843-839-4711
Mailing Address - Fax:
Practice Address - Street 1:4610 OLEANDER DR STE 102
Practice Address - Street 2:
Practice Address - City:MYRTLE BEACH
Practice Address - State:SC
Practice Address - Zip Code:29577-5752
Practice Address - Country:US
Practice Address - Phone:864-313-6656
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-10-07
Last Update Date:2023-02-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC102591223P0300X
SC9381122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist
No1223P0300XDental ProvidersDentistPeriodontics