MEDICARE: DR. JOSEPH DAVID COHN JR. DDS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	122300000X	Dentist	4978	MD

General Provider Information

NPI Number	:	1457427296
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOSEPH DAVID COHN JR. DDS

Provider Business Mailing Address
First Line	:	PO BOX 489
Second Line	:
City	:	CECILTON
State	:	MD
Zip	:	21913-0489
Country	:	US
Telephone Number	:	410-275-2225
Fax Number	:	410-275-2423

Provider Business Practice Location Address
First Line	:	121 SOUTH BOHEMIA AVENUE
Second Line	:
City	:	CECILTON
State	:	MD
Zip	:	21913-0489
Country	:	US
Telephone Number	:	410-275-2225
Fax Number	:	410-275-2423

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/24/2006
Last Update Date	:	07/08/2007

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