Provider Demographics
NPI:1952595001
Name:ENDODONTICARE, P.C.
Entity Type:Organization
Organization Name:ENDODONTICARE, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:HENRY
Authorized Official - Middle Name:P
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:203-777-6461
Mailing Address - Street 1:1 CENTURY TOWER
Mailing Address - Street 2:265 CHURCH STREET
Mailing Address - City:NEW HAVEN
Mailing Address - State:CT
Mailing Address - Zip Code:06510-7013
Mailing Address - Country:US
Mailing Address - Phone:203-777-6461
Mailing Address - Fax:
Practice Address - Street 1:1 CENTURY TOWER
Practice Address - Street 2:265 CHURCH STREET
Practice Address - City:NEW HAVEN
Practice Address - State:CT
Practice Address - Zip Code:06510-7013
Practice Address - Country:US
Practice Address - Phone:203-777-6461
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-08-31
Last Update Date:2007-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CT35561223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty