Provider Demographics
NPI:1861590572
Name:M. COBIN INC., J BOLLINGER DDS. INC. R. STOOPS CONEJO-SIMI ENDODONTICS
Entity type:Organization
Organization Name:M. COBIN INC., J BOLLINGER DDS. INC. R. STOOPS CONEJO-SIMI ENDODONTICS
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:RYAN
Authorized Official - Middle Name:CURTIS
Authorized Official - Last Name:STOOPS
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:805-495-4601
Mailing Address - Street 1:176 AUBURN CT
Mailing Address - Street 2:SUITE 6
Mailing Address - City:WESTLAKE VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91362-3614
Mailing Address - Country:US
Mailing Address - Phone:805-495-4601
Mailing Address - Fax:805-495-0861
Practice Address - Street 1:176 AUBURN CT
Practice Address - Street 2:SUITE 6
Practice Address - City:WESTLAKE VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91362-3614
Practice Address - Country:US
Practice Address - Phone:805-495-4601
Practice Address - Fax:805-495-0861
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2016-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA256911223E0200X
CA466931223E0200X
CA272391223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty