Provider Demographics
NPI:1528237740
Name:DAVID C COTTY DMD & ASSOCIATES PA
Entity type:Organization
Organization Name:DAVID C COTTY DMD & ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER OPERATOR
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:C
Authorized Official - Last Name:COTTY
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:828-894-2000
Mailing Address - Street 1:816 WEST MILLS STREET
Mailing Address - Street 2:SUITE E
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722
Mailing Address - Country:US
Mailing Address - Phone:828-894-2000
Mailing Address - Fax:828-894-2004
Practice Address - Street 1:816 WEST MILLS STREET
Practice Address - Street 2:SUITE E
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722
Practice Address - Country:US
Practice Address - Phone:828-894-2000
Practice Address - Fax:828-894-2004
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-02-21
Last Update Date:2008-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC7991816Medicaid
NC91816OtherBCBS