Healthcare Provider Details

I. General information

NPI: 1326897810
Provider Name (Legal Business Name): GARY A. COHEN, D.D.S., P.C.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/16/2024
Last Update Date: 05/16/2024
Certification Date: 05/16/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

27560 CHERRY HILL RD
GARDEN CITY MI
48135-3152
US

IV. Provider business mailing address

27560 CHERRY HILL RD
GARDEN CITY MI
48135-3152
US

V. Phone/Fax

Practice location:
  • Phone: 734-422-5480
  • Fax: 734-422-3446
Mailing address:
  • Phone: 734-422-5480
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code261QD0000X
TaxonomyDental Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: KATHIE SCHABEL
Title or Position: MANAGER
Credential:
Phone: 734-422-5480