Provider Demographics
NPI:1336651082
Name:COHEN DENTAL STUDIO PLLC
Entity Type:Organization
Organization Name:COHEN DENTAL STUDIO PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:NEIL
Authorized Official - Middle Name:D
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:239-351-2000
Mailing Address - Street 1:700 2ND AVE N STE 303
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34102-5702
Mailing Address - Country:US
Mailing Address - Phone:239-351-2000
Mailing Address - Fax:239-351-1880
Practice Address - Street 1:700 2ND AVE N STE 303
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34102-5702
Practice Address - Country:US
Practice Address - Phone:239-351-2000
Practice Address - Fax:239-351-1880
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-11-02
Last Update Date:2017-11-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
1223G0001X
FLDN168431223P0300X
FLDN204411223P0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223P0700XDental ProvidersDentistProsthodonticsGroup - Multi-Specialty
No1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty
No1223P0300XDental ProvidersDentistPeriodonticsGroup - Multi-Specialty