Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 1223P0300X | Periodontist | DN17218 | FL |
NPI | 1154496685 |
---|---|
Provider Name | Dr. Scott Gershon Cohen |
First Address | Winter Park, FL 32789 |
Second Address | Winter Park, FL 32789 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 21/11/2006 |
Last Update Date | 08/07/2007 |