Provider Demographics
NPI:1205071982
Name:CATREEN COHEN DDS, A PROFESSIONAL DENTAL CORPORATION
Entity type:Organization
Organization Name:CATREEN COHEN DDS, A PROFESSIONAL DENTAL CORPORATION
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CATREEN
Authorized Official - Middle Name:
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:310-429-6786
Mailing Address - Street 1:814 E BROADWAY STE 4
Mailing Address - Street 2:
Mailing Address - City:GLENDALE
Mailing Address - State:CA
Mailing Address - Zip Code:91205-1218
Mailing Address - Country:US
Mailing Address - Phone:818-241-1160
Mailing Address - Fax:818-241-1320
Practice Address - Street 1:814 E BROADWAY STE 4
Practice Address - Street 2:
Practice Address - City:GLENDALE
Practice Address - State:CA
Practice Address - Zip Code:91205-1218
Practice Address - Country:US
Practice Address - Phone:818-241-1160
Practice Address - Fax:818-241-1320
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-12-09
Last Update Date:2008-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA498611223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty