Provider Demographics
NPI:1821057597
Name:COHEN, LAWRENCE (DDS)
Entity Type:Individual
Prefix:DR
First Name:LAWRENCE
Middle Name:
Last Name:COHEN
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 1:2300 N CRAYCROFT RD
Mailing Address - Street 2:SUITE #2
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85712-2808
Mailing Address - Country:US
Mailing Address - Phone:520-298-5556
Mailing Address - Fax:
Practice Address - Street 1:2300 N CRAYCROFT RD
Practice Address - Street 2:SUITE #2
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85712-2808
Practice Address - Country:US
Practice Address - Phone:520-298-5556
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-03-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ1986122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist