Organization
ROCKAWAY BEACH ORTHODONTICS, PC
Active
Other names
Rockaway Beach Orthodontics and Pediatric Dentistry
Organization subpart
No
Provider details
NPI number
Authorized official
DR. EVAN COHEN DDS (OWNER)
(718) 924-2091
Entity
Organization
Contact information
Practice address
11412 BEACH CHANNEL DR STE 4, ROCKAWAY PARK, NY 11694-2215
(718) 924-2091
Mailing address
11412 BEACH CHANNEL DR STE 4, ROCKAWAY PARK, NY 11694-2215
(718) 924-2091
Taxonomy
Speciality
Code
Description
License number
State
1223P0221X
Pediatric Dentistry
—
—
1223X0400X
Orthodontics and Dentofacial Orthopedics Dentistry
Primary
—
—
Other
Enumeration date
03/04/2019
Last updated
03/04/2019
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