Provider Demographics
NPI:1881957603
Name:COHN, GREGORY DAVID (DMD)
Entity type:Individual
Prefix:DR
First Name:GREGORY
Middle Name:DAVID
Last Name:COHN
Suffix:
Gender:M
Credentials:DMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:44-20 DOUGLASTON PKWY
Mailing Address - Street 2:SUITE 1-F
Mailing Address - City:DOUGLASTON
Mailing Address - State:NY
Mailing Address - Zip Code:11363-1841
Mailing Address - Country:US
Mailing Address - Phone:718-428-2212
Mailing Address - Fax:718-229-2704
Practice Address - Street 1:44-20 DOUGLASTON PKWY
Practice Address - Street 2:SUITE 1-F
Practice Address - City:DOUGLASTON
Practice Address - State:NY
Practice Address - Zip Code:11363-1841
Practice Address - Country:US
Practice Address - Phone:718-428-2212
Practice Address - Fax:718-229-2704
Is Sole Proprietor?:Yes
Enumeration Date:2012-06-18
Last Update Date:2012-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY040706122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes122300000XDental ProvidersDentist