# SHANNON M. COEN D.M.D, PC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659793115
- **Authorized official:** DR. SHANNON M COEN D.M.D. (OWNER/PRESIDENT)
- **Authorized official phone:** (651) 398-9686

## Contact information

- **Practice address:** 16080 N 59TH AVE STE A, GLENDALE, AZ 85306-2339
- **Practice address phone:** (651) 398-9686
- **Mailing address:** 16080 N 59TH AVE STE A, GLENDALE, AZ 85306-2339
- **Mailing address phone:** (651) 398-9686

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 261QD0000X | Dental Clinic/Center | D7588 | AZ | Yes |

## Other

- **Enumeration date:** 01/16/2014
- **Last updated:** 01/16/2014