John Stephen Cockerham, D.D.S. Valid NPI

Individual provider · Oral and Maxillofacial Surgery (Dentist) · Hattiesburg, MS

NPI

1689762528

Type

Individual (Type 1)

Primary specialty

Oral and Maxillofacial Surgery (Dentist) (Dentist)

Specialty group

Dental Providers

Taxonomy code

1223S0112X

License number

OS 20-77 (MS)

Sex

Male

Sole proprietor

No

Enumerated

2006-10-10

Last updated

2007-07-08