Provider Demographics
NPI:1598850240
Name:COHEN, LESTER F (DMD)
Entity Type:Individual
Prefix:DR
First Name:LESTER
Middle Name:F
Last Name:COHEN
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 1:1815 SATELLITE BLVD
Mailing Address - Street 2:SUITE 401
Mailing Address - City:DULUTH
Mailing Address - State:GA
Mailing Address - Zip Code:30097-5237
Mailing Address - Country:US
Mailing Address - Phone:770-813-1200
Mailing Address - Fax:770-813-1803
Practice Address - Street 1:1815 SATELLITE BLVD
Practice Address - Street 2:SUITE 401
Practice Address - City:DULUTH
Practice Address - State:GA
Practice Address - Zip Code:30097-5237
Practice Address - Country:US
Practice Address - Phone:770-813-1200
Practice Address - Fax:770-813-1803
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-04
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GADN0091511223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1223G0001XDental ProvidersDentistGeneral Practice