Provider Demographics
NPI:1700984523
Name:A. SCOTT COHEN, D.D.S., MARK D. STEVENSON, D.D.S., A PROFESSIONAL CORP
Entity type:Organization
Organization Name:A. SCOTT COHEN, D.D.S., MARK D. STEVENSON, D.D.S., A PROFESSIONAL CORP
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:A.
Authorized Official - Middle Name:SCOTT
Authorized Official - Last Name:COHEN
Authorized Official - Suffix:
Authorized Official - Credentials:DDS
Authorized Official - Phone:925-676-3000
Mailing Address - Street 1:2222 EAST ST
Mailing Address - Street 2:350
Mailing Address - City:CONCORD
Mailing Address - State:CA
Mailing Address - Zip Code:94520-2084
Mailing Address - Country:US
Mailing Address - Phone:925-676-3000
Mailing Address - Fax:925-676-3001
Practice Address - Street 1:2222 EAST ST
Practice Address - Street 2:350
Practice Address - City:CONCORD
Practice Address - State:CA
Practice Address - Zip Code:94520-2084
Practice Address - Country:US
Practice Address - Phone:925-676-3000
Practice Address - Fax:925-676-3001
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-20
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CA412421223E0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1223E0200XDental ProvidersDentistEndodonticsGroup - Single Specialty