Provider Demographics
NPI:1508994567
Name:JAMES A COGLIANESE DDS MS LTD
Entity Type:Organization
Organization Name:JAMES A COGLIANESE DDS MS LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:A
Authorized Official - Last Name:COGLIANESE
Authorized Official - Suffix:
Authorized Official - Credentials:DDS MS
Authorized Official - Phone:708-448-8400
Mailing Address - Street 1:7350 WEST COLLEGE DRIVE
Mailing Address - Street 2:
Mailing Address - City:PALOS HEIGHTS
Mailing Address - State:IL
Mailing Address - Zip Code:60463-1149
Mailing Address - Country:US
Mailing Address - Phone:708-448-8400
Mailing Address - Fax:
Practice Address - Street 1:7350 WEST COLLEGE DRIVE
Practice Address - Street 2:
Practice Address - City:PALOS HEIGHTS
Practice Address - State:IL
Practice Address - Zip Code:60463-1149
Practice Address - Country:US
Practice Address - Phone:708-448-8400
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-01
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Not Answered122300000XDental ProvidersDentistGroup - Multi-Specialty
Not Answered1223X0400XDental ProvidersDentistOrthodontics and Dentofacial OrthopedicsGroup - Multi-Specialty