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General NPI Number Information
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NPI Number | 1386865236
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Entity Type | Organization
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Legal Business Name | MARC D. COHEN, D.D.S. AND JANA L. KAYE, D.D.S., DENTAL CORP.
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Dates
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Enumeration Date | 05/01/2007
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Last Update Date | 11/10/2010
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Provider Practice Location Address
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Address Line | 16311 VENTURA BOULEVARD SUITE 1250
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City | ENCINO
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State | CA
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Zip | 91436
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Country | US
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Telephone | 818-789-0555
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Fax | 818-789-5011
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Provider Business Mailing Address
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Address Line | 16311 VENTURA BOULEVARD SUITE 1250
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City | ENCINO
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State | CA
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Zip | 91436
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Country | US
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Telephone | 818-789-0555
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Fax | 818-789-5011
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Authorized Official
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Title or Position | DENTIST'S & OWNER'S
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Name | DR. MARK D COHEN
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Credential | D.D.S.
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Telephone | 818-789-0555
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223G0001X
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Taxonomy Name | General Practice Dentistry
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License Number |
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License Number State |
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