Provider Demographics
NPI:1790226884
Name:ROBERT L. COHEN, D.D.S A PROFESSIONAL CORPORATION
Entity Type:Organization
Organization Name:ROBERT L. COHEN, D.D.S A PROFESSIONAL CORPORATION
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST/OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:LAWRENCE
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:818-990-7260
Mailing Address - Street 1:4333 WOODMAN AVE
Mailing Address - Street 2:
Mailing Address - City:SHERMAN OAKS
Mailing Address - State:CA
Mailing Address - Zip Code:91423-3030
Mailing Address - Country:US
Mailing Address - Phone:818-990-7260
Mailing Address - Fax:818-990-1643
Practice Address - Street 1:4333 WOODMAN AVE
Practice Address - Street 2:
Practice Address - City:SHERMAN OAKS
Practice Address - State:CA
Practice Address - Zip Code:91423-3030
Practice Address - Country:US
Practice Address - Phone:818-990-7260
Practice Address - Fax:818-990-1643
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-03-09
Last Update Date:2017-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA269721223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Single Specialty