Provider Demographics
NPI:1609973635
Name:COTTY, DAVID CHARLES (DMD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:CHARLES
Last Name:COTTY
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:816 W MILLS ST
Mailing Address - Street 2:SUITE E
Mailing Address - City:COLUMBUS
Mailing Address - State:NC
Mailing Address - Zip Code:28722-8496
Mailing Address - Country:US
Mailing Address - Phone:828-894-2000
Mailing Address - Fax:828-894-2004
Practice Address - Street 1:816 W MILLS ST
Practice Address - Street 2:SUITE E
Practice Address - City:COLUMBUS
Practice Address - State:NC
Practice Address - Zip Code:28722-8496
Practice Address - Country:US
Practice Address - Phone:828-894-2000
Practice Address - Fax:828-894-2004
Is Sole Proprietor?:No
Enumeration Date:2006-09-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC54371223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC91816OtherBLUE CROSS BLUE SHIELD
NC7991816Medicaid