Provider Demographics
NPI:1437354214
Name:BOHLIN, DENNIS P (DDS)
Entity Type:Individual
Prefix:DR
First Name:DENNIS
Middle Name:P
Last Name:BOHLIN
Suffix:
Gender:M
Credentials:DDS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:200 WEST 57 TH STREET
Mailing Address - Street 2:1110
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10019-3211
Mailing Address - Country:US
Mailing Address - Phone:212-586-2333
Mailing Address - Fax:212-977-5571
Practice Address - Street 1:200 W 57TH ST
Practice Address - Street 2:1110
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10019-3211
Practice Address - Country:US
Practice Address - Phone:212-586-2333
Practice Address - Fax:212-977-5571
Is Sole Proprietor?:Yes
Enumeration Date:2007-06-20
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0343201223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice