| Omar T Cockey Dmd Pa | |
|
703 Main St Paterson NJ 07503-2621 | |
| (973) 779-6183 | |
| (973) 779-6183 |
| Full Name | Omar T Cockey Dmd Pa |
|---|---|
| Speciality | Clinic/center - Dental |
| Location | 703 Main St, Paterson, New Jersey |
| Authorized Official Name and Position | Omar T Cockey (CEO) |
| Authorized Official Contact | 9737796183 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Omar T Cockey Dmd Pa Po Box 115 Montclair NJ 07042-0115 Ph: (973) 779-6183 | Omar T Cockey Dmd Pa 703 Main St Paterson NJ 07503-2621 Ph: (973) 779-6183 |
| NPI Number | 1043519416 |
|---|---|
| Provider Enumeration Date | 03/24/2011 |
| Last Update Date | 03/24/2011 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043519416 | NPI | - | NPPES |
| 4608909 | Medicaid | NJ |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261Q00000X | Clinic/center | DI 17684 (New Jersey) | Secondary |
| 261QD0000X | Clinic/center - Dental | DI 17684 (New Jersey) | Primary |
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