MEDICARE: C COHEN DENTAL GROUP, INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1223G0001X	General Practice Dentistry	49861	CA

General Provider Information

NPI Number	:	1760762421
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	C COHEN DENTAL GROUP, INC

Provider Business Mailing Address
First Line	:	269 S BEVERLY DR # 468
Second Line	:
City	:	BEVERLY HILLS
State	:	CA
Zip	:	90212-3851
Country	:	US
Telephone Number	:	213-484-2186
Fax Number	:

Provider Business Practice Location Address
First Line	:	1919 W 7TH ST UNIT B
Second Line	:
City	:	LOS ANGELES
State	:	CA
Zip	:	90057-4103
Country	:	US
Telephone Number	:	213-484-2186
Fax Number	:

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. CATREEN COHEN
Credential	:	DDS
Telephone Number	:	310-429-6786

Provider Enumeration Date	:	08/25/2011
Last Update Date	:	06/04/2012

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