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General NPI Number Information
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NPI Number | 1679767594
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Entity Type | Organization
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Legal Business Name | COHLMIA ORTHODONTICS
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Dates
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Enumeration Date | 09/04/2007
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Last Update Date | 09/04/2007
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Provider Practice Location Address
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Address Line | 13313 N MERIDIAN AVE SUITE D-4
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8380
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Country | US
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Telephone | 405-751-0300
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Fax | 405-751-0966
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Provider Business Mailing Address
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Address Line | 13313 N MERIDIAN AVE SUITE D-4
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City | OKLAHOMA CITY
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State | OK
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Zip | 73120-8380
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Country | US
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Telephone | 405-751-0300
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Fax | 405-751-0966
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Authorized Official
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Title or Position | OWNER
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Name | DR. JEFFREY TODD COHLMIA
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Credential | D.D.S., M.S.
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Telephone | 405-751-0300
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 4966
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License Number State | OK
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