Provider Demographics
NPI:1396910550
Name:MATTHEW COHLMIA, D.D.S., INC. P.C.
Entity type:Organization
Organization Name:MATTHEW COHLMIA, D.D.S., INC. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DENTIST
Authorized Official - Prefix:DR
Authorized Official - First Name:MATTHEW
Authorized Official - Middle Name:E
Authorized Official - Last Name:COHLMIA
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:405-848-3783
Mailing Address - Street 1:3727 NW 63RD ST
Mailing Address - Street 2:SUITE 310
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73116-1931
Mailing Address - Country:US
Mailing Address - Phone:405-848-3783
Mailing Address - Fax:405-848-4088
Practice Address - Street 1:3727 NW 63RD ST
Practice Address - Street 2:SUITE 310
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73116-1931
Practice Address - Country:US
Practice Address - Phone:405-848-3783
Practice Address - Fax:405-848-4088
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2008-04-28
Last Update Date:2016-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK50481223G0001X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223G0001XDental ProvidersDentistGeneral PracticeGroup - Multi-Specialty