Provider Demographics
NPI:1932231206
Name:COHN DENTAL ASSOCIATES,LLC
Entity Type:Organization
Organization Name:COHN DENTAL ASSOCIATES,LLC
Other - Org Name:COHN DENTAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MARC
Authorized Official - Middle Name:PHILLIP
Authorized Official - Last Name:COHN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:414-228-3000
Mailing Address - Street 1:6025 N GREEN BAY AVE
Mailing Address - Street 2:
Mailing Address - City:MILWAUKEE
Mailing Address - State:WI
Mailing Address - Zip Code:53209-3811
Mailing Address - Country:US
Mailing Address - Phone:414-228-3000
Mailing Address - Fax:414-228-3002
Practice Address - Street 1:6025 N GREEN BAY AVE
Practice Address - Street 2:
Practice Address - City:MILWAUKEE
Practice Address - State:WI
Practice Address - Zip Code:53209-3811
Practice Address - Country:US
Practice Address - Phone:414-228-3000
Practice Address - Fax:414-228-3002
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-12
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI4000508-015122300000X
WI40003015-015122300000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes122300000XDental ProvidersDentistGroup - Single Specialty