Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0700X | Prosthodontist | DS4667 | TN |
NPI | 1245374271 |
---|---|
Provider Name | Dr. Marc A. Cohen |
First Address | Memphis, TN 38119-3664 |
Second Address | Memphis, TN 38119-3664 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2007 |
Last Update Date | 08/07/2007 |