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General NPI Number Information
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NPI Number | 1356661672
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Entity Type | Organization
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Legal Business Name | LAURENCE D. COHEN, DDS, INC.
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Dates
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Enumeration Date | 06/09/2010
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Last Update Date | 06/09/2010
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Provider Practice Location Address
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Address Line | 14610 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-1521
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Country | US
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Telephone | 310-676-4746
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Fax | 310-676-0944
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Provider Business Mailing Address
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Address Line | 14610 HAWTHORNE BLVD
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City | LAWNDALE
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State | CA
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Zip | 90260-1521
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LAURENCE DAVID COHEN
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Credential |
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Telephone | 310-378-8861
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QD0000X
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Taxonomy Name | Dental Clinic/Center
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License Number | 21862
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License Number State | CA
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