Provider Demographics
NPI:1144671926
Name:COHN, ROXANNA LYNN (CDA COMSA EFDA)
Entity type:Individual
Prefix:MRS
First Name:ROXANNA
Middle Name:LYNN
Last Name:COHN
Suffix:
Gender:F
Credentials:CDA COMSA EFDA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7706 NW TAYLOR AVE
Mailing Address - Street 2:
Mailing Address - City:LAWTON
Mailing Address - State:OK
Mailing Address - Zip Code:73505-2433
Mailing Address - Country:US
Mailing Address - Phone:580-284-6728
Mailing Address - Fax:580-442-4002
Practice Address - Street 1:652 HAMILTON ROAD
Practice Address - Street 2:
Practice Address - City:FORT SILL
Practice Address - State:OK
Practice Address - Zip Code:73503
Practice Address - Country:US
Practice Address - Phone:580-442-3905
Practice Address - Fax:580-442-4002
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes126800000XDental ProvidersDental Assistant