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General NPI Number Information
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NPI Number | 1740533629
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Entity Type | Organization
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Legal Business Name | GARY D. COHEN, DDS PC
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Dates
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Enumeration Date | 10/17/2012
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Last Update Date | 10/17/2012
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Provider Practice Location Address
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Address Line | 100 SPRINGHOUSE CT SUITE #200
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1609
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Country | US
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Telephone | 615-824-8929
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Fax | 615-822-3330
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Provider Business Mailing Address
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Address Line | 100 SPRINGHOUSE CT SUITE #200
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City | HENDERSONVILLE
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State | TN
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Zip | 37075-1609
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Country | US
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Telephone | 615-824-8929
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Fax | 615-822-3330
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Authorized Official
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Title or Position | FINANCIAL COORDINATOR
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Name | MARK CONDER
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Credential |
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Telephone | 615-824-8929
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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 | DS-8792
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License Number State | TN
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