Provider Demographics
NPI:1295975977
Name:JASON H. COHEN, DMD, LLC
Entity type:Organization
Organization Name:JASON H. COHEN, DMD, LLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER/SOLE PROPRIETOR
Authorized Official - Prefix:DR
Authorized Official - First Name:JASON
Authorized Official - Middle Name:H
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DMD
Authorized Official - Phone:843-216-2517
Mailing Address - Street 1:198 RUTLEDGE AVE STE 3
Mailing Address - Street 2:
Mailing Address - City:CHARLESTON
Mailing Address - State:SC
Mailing Address - Zip Code:29403-5834
Mailing Address - Country:US
Mailing Address - Phone:843-216-2517
Mailing Address - Fax:843-577-2826
Practice Address - Street 1:198 RUTLEDGE AVE STE 3
Practice Address - Street 2:
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29403-5834
Practice Address - Country:US
Practice Address - Phone:843-216-2517
Practice Address - Fax:843-577-2826
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-02-20
Last Update Date:2009-02-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC35201223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty