Individual
GARY A. COHEN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.D.S.
Contact information
Practice address
27560 CHERRY HILL RD, GARDEN CITY, MI 48135-3156
(734) 422-5480
(734) 422-3446
Mailing address
27560 CHERRY HILL RD, GARDEN CITY, MI 48135-3156
(734) 422-5480
(734) 422-3446
Taxonomy
Speciality
Code
Description
License number
State
1223G0001X
General Practice Dentistry
Primary
15102
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
15102
STATE LICENSE NUMBER
MI
01
—
718876
UNITED CONCORDIA
MI
Enumeration date
11/03/2006
Last updated
07/09/2007
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