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General NPI Number Information
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NPI Number | 1548552615
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Entity Type | Organization
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Legal Business Name | SHELDON C COHEN DMD PC DBA PREMIER DENTAL PARTNERS
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Dates
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Enumeration Date | 05/09/2011
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Last Update Date | 05/09/2011
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Provider Practice Location Address
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Address Line | 2264 BLUESTONE DR
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City | SAINT CHARLES
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State | MO
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Zip | 63303-5981
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Country | US
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Telephone | 636-947-3737
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Fax |
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Provider Business Mailing Address
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Address Line | 22 N EUCLID AVE SUITE 220
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City | SAINT LOUIS
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State | MO
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Zip | 63108-1407
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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 | INSURANCE COORDINATOR
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Name | KRISTINA ANDREATTA
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Credential |
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Telephone | 314-361-0760
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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 | 13723
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License Number State | MO
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