Healthcare Provider Details

I. General information

NPI: 1306063615
Provider Name (Legal Business Name): SOL COEHN-SEDGH, D.D.S., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/19/2007
Last Update Date: 08/22/2020
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1730 SEPULVEDA BLVD SUITE 1
TORRANCE CA
90501-5645
US

IV. Provider business mailing address

1730 SEPULVEDA BLVD SUITE 1
TORRANCE CA
90501-5645
US

V. Phone/Fax

Practice location:
  • Phone: 310-325-8888
  • Fax: 310-325-3024
Mailing address:
  • Phone: 310-325-8888
  • Fax: 310-325-3024

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1223G0001X
TaxonomyGeneral Practice Dentistry
License Number38979
License Number StateCA

VIII. Authorized Official

Name: SOLEYMAN COHEN
Title or Position: OWNER
Credential:
Phone: 310-325-8888