Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223D0001X | Dental Public Health | DN8488 | FL |
NPI | 1215039441 |
---|---|
Provider Name | Dan D. Cober |
First Address | Tallahassee, FL 32310-4348 |
Second Address | Tallahassee, FL 32310-4348 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 01/09/2006 |
Last Update Date | 13/09/2013 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
0727393-00 | (05) | FL |