Provider Demographics
NPI:1699871459
Name:COBBETT, JUDITH ANN (DDS)
Entity type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:ANN
Last Name:COBBETT
Suffix:
Gender:F
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2580 LAUREL ST
Mailing Address - Street 2:
Mailing Address - City:BEAUMONT
Mailing Address - State:TX
Mailing Address - Zip Code:77702-2306
Mailing Address - Country:US
Mailing Address - Phone:409-835-3450
Mailing Address - Fax:409-835-0450
Practice Address - Street 1:2580 LAUREL ST
Practice Address - Street 2:
Practice Address - City:BEAUMONT
Practice Address - State:TX
Practice Address - Zip Code:77702-2306
Practice Address - Country:US
Practice Address - Phone:409-835-3450
Practice Address - Fax:409-835-0450
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-16
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX113071223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice