Individual
JASON M COHEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DDS
Contact information
Practice address
1805 FORT ST, WYANDOTTE, MI 48192-3545
(734) 283-1263
Mailing address
14420 EUREKA RD, SOUTHGATE, MI 48195
(734) 283-1263
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
2901017871
MI
Other
Enumeration date
02/23/2006
Last updated
11/06/2015
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