Provider Demographics
NPI:1144667759
Name:MAXJCOHEN, D.D.S., P.C.
Entity type:Organization
Organization Name:MAXJCOHEN, D.D.S., P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:MAX
Authorized Official - Middle Name:J
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:770-457-1351
Mailing Address - Street 1:4700 CHAMBLEE DUNWOODY RD
Mailing Address - Street 2:SUITE #100
Mailing Address - City:DUNWOODY
Mailing Address - State:GA
Mailing Address - Zip Code:30338-6054
Mailing Address - Country:US
Mailing Address - Phone:770-457-1351
Mailing Address - Fax:770-457-3655
Practice Address - Street 1:4700 CHAMBLEE DUNWOODY RD
Practice Address - Street 2:SUITE #100
Practice Address - City:DUNWOODY
Practice Address - State:GA
Practice Address - Zip Code:30338-6054
Practice Address - Country:US
Practice Address - Phone:770-457-1351
Practice Address - Fax:770-457-3655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-05-23
Last Update Date:2013-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QD0000XAmbulatory Health Care FacilitiesClinic/CenterDental